Practice Management & EHR, chapter 9 – Flashcards

Unlock all answers in this set

Unlock answers
question
modifier
answer
A number appended to a code to report particular facts
question
adjustments
answer
Changes to a patient's account
question
unbundling
answer
The incorrect billing practice of breaking a panel or package of serves/procedures into component.
question
code linkage
answer
The clinically appropriate connection between a provided service and a patient's condition or illness.
question
charge capture
answer
The process of recording billable services
question
compliant billing
answer
Billing actions that satisfy official requirements
question
query
answer
A request for more information from a provider
question
CCI modifier indicators
answer
The numbers showing if the use of a modifier can bypass a CCI
question
global period
answer
The days surrounding a surgical procedure when all services relating to the procedure are considered part of the surgical package.
question
bundled code
answer
Two or more related procedure codes combined into one
question
T/F In Medisoft, the Unprocessed Charges window displays transactions transmitted from the EHR program that have already been posted in Medisoft.
answer
F
question
T/F Patients who do not have insurance coverage are called self-pay patients.
answer
T
question
T/F A modifier usually affects the normal level of reimbursement for the code to which it is attached.
answer
T
question
T/F In Medisoft Clinical Records, some patient education hand-outs are available in English and in Spanish.
answer
T
question
T/F Payments are entered in two different areas of the Medisoft program: the Transaction Entry dialog box, and the Deposit List dialog box.
answer
T
question
T/F The amount of copayment that is due depends on whether the provider is in the patient's network and on the type of service.
answer
T
question
T/F Noncompliant billing refers to flowing these rules os that the practice and the health plan have the same expectations for the payment that will be made.
answer
F
question
T/F CCI edits apply to claims that bill for more than one procedure performed on the same patient, on the same date of service, by the same performing provider.
answer
T
question
T/F Walkouts receipts include only information on the procedures and diagnosis for patient visit
answer
F
question
T/F PM/EHRs typically have a capability called claim scrubbing.
answer
T
question
________ are changes to patient's accounts.
answer
Adjustments
question
_________ are the amounts a provider bills for the services performed.
answer
Charges
question
___________ are monies received from patients and insurance carriers.
answer
Payments
question
_________ describes the connection between a procedure code and the related diagnosis code(s).
answer
Code linkage
question
__________ is the incorrect billing practice of breaking a panel or package of services/procedures into component parts.
answer
Unbundling
question
________ refers to following billing rules so that the practice and the health plan have the same expectations for the payment that will be made.
answer
Complaint billing
question
_________ is the process of recording billable services.
answer
Charge capture
question
________ are groups of procedure code entries that relate to a single activity.
answer
MultiLink codes
question
A _________ is a group of related procedures and/or services included under a single code.
answer
package
question
A __________ is a number appended to a code to report particular facts.
answer
modifier
question
RTCA
answer
real-time claim adjudication
question
MUE
answer
medically unlikely edit
question
MEC
answer
mutually exclusive code
question
CCI
answer
correct coding initiative
question
POS
answer
place of service
Get an explanation on any task
Get unstuck with the help of our AI assistant in seconds
New