Test review 116-4 – Flashcards

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question
Exchange of data in a standardized format through computer connections is known as electronic data interchange.
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...True
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Encrypted data often look like gibberish to unautherized users.
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...True
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Submitting a claim to Medicare, the name of the insured is required, not situational.
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...True
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Medicare claim must include standard code sets, such as CPT and ICD-9 codes.
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...True
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Confidential data should be stored only in the computer's hard drive.
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...False
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An installed firewall and antivirus software help maintain computer security.
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True
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Practice management systems can be "rented" from practice management systems over the internet.
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...True
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For insurance claims to be submitted electronically, a sign by the physician with the carriers involved is necessary.
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...True
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Group of insurance claims sent at the same time from one facility is known as a?
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...batch
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A clearing house is a/an?
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...An entity that receives the electronic transmission of claims from the health care provider's office and translates it into a standard format prescibed in HIPPA regulations
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Insurance claims transmitted elctronically are usually paid in?
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...Two weeks or less
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The most important function of a practice management system is?
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...Accounts Recievable
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The employer's identification number is assigned by?
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...IRS "Internal Revenue Service'
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A clearing house?
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...* Separate claims by carrier * Perform software edits on each claim to check errors * Transmit claims electronically to the correct insurance payer
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Insurance claims form data are gathered?
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...* Before Service Rendered * During Service Rendered * After Service Rendered
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Back-up copies of office records should be stored?
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...Off site Away from the office in case of fire, flood, or theft
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When a medical practice has its own computer and transmits claims electronically directly to the insurance carrier, this system is known as?
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...carrier-direct
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A computer printout that used to look for errors before an insurance claim is transmitted electronically is called?
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...insurance billing worksheet
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Back and forth communication between user and computer that occurs during online real time is called?
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...Interactive transaction
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Assigning a code to represent data is known as?
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...Encryption
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Combination of letters, numbers, or symbols that each individual is assigned to access computer the system is called a/an?
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...Password
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When keying data, it is wise to______frequently to save information.
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...Back-up
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An online transaction concerning the status of an INS. claim is called?
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...ERA----- Electronic Remittance Advice
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Employee's who have access to patient's medical records must have a high degree of_____and______.
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...Responsibility and Accountability
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A status report of claims is usually received?
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...Electronically
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For assignment of benefits, each patient's______must be obtained.
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...Authorized Signature
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A screen prompt is a _______?
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...Question
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An internal audit that reviews who has access to PHI. is a/an_________safeguard or security measure.
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...Administrative
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Automatic logoff that prevents unauthorized users from accessing a computer is a/an_______safeguard.How the physician handles the retention, removal, and disposal of paper records is a/an________safeguard.
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...Technical and Physical safeguard
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Post payment in practice management system.
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...Daily
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Note any problematic claims and resolve outstanding files.
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...Weekly
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Batch, scrub, edit and transmit claims.
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...Daily and Weekly
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review all claims rejection report.
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...End of Month
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Audit claims batched and transmitted with conformation reports.
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...Daily
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Make follow up calls to resolve reasons for rejections.
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...Weekly
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Review clearinghouse/payer transmission reports.
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...Daily
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Correct rejections and resubmit claims.
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...Daily
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update practice management system with payer information.
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...End of Month
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Research unpaid claims.
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...Weekly
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@
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at
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BMT
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Bone Marrow Transplantation
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BSE
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Breast Self Examination
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cc
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cubic centimeter (same as ml: 1/1000 of liter
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AP
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Anterior Posterior
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AUB
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Abnormal Uterine Bleeding
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C
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Carbon ; Calorie
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c/o
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complaint of
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CC
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Chief Complaint
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BSO
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Bilateral Salpingo Oophoectomy
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