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2 Computerized Medical Billing Flashcards

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3241175000administrative safeguardspolicies and procedures designed to protect electronic health information outlined by the HIPAA Security Rule0
3241175973audit/edit reporta report from a clearinghouse that lists errors to be corrected before a claim can be submitted to the payer1
3241175974audit traila report that traces who has accessed electronic information, when the information was accessed, and whether any information was changed2
3241175975autopostingan automated process for entering information from a remittance advice (RA) into a practice management program3
3241176687breachthe acquisition, access, use, or disclosure of unsecured PHI in a manner not permitted under the HIPAA Privacy Rule4
3241176688clearinghousea company that receives claims from a provider, prepares them for processing, and transmits them to the payers in HIPAA-compliant format5
3241178914CMS-1500 (8/05)the mandated paper insurance claim6
3241179433computer-assisted codingassigning preliminary diagnosis and procedure codes using computer software7
3241180418electronic data interchange (EDI)the exchange of routine business transactions from one computer to another using publicly available communications protocols8
3241180850electronic funds transfer (EFT)the electronic routing of funds between banks9
3241181598electronic medical records (EMRs)the computerized records of one physician's encounters with a patient over time10
3241181599electronic prescribingthe use of computers and hand-held devices to transmit prescriptions in digital format11
3241182174evidence-based medicinemedical care based on the latest and most accurate clinical research12
3241182175health information technology (HIT)technology that is used to record, store, and manage patient health care information13
3241183323Health Information Technology for Economic and Clinical Health Act (HITECH)part of the American Recovery and Reinvestment Act of 2009 that provides financial incentives to physicians and hospitals to adopt EHRs and strengthens HIPAA privacy and security regulations14
3241184444Health Insurance Portability with Accountability ACT of 1996 (HIPAA)federal act that set forth guidelines for standardizing the electronic data interchange of administrative and financial transactions, exposing fraud and abuse in government programs, and protecting the security and privacy of health information15
3241184871HIPAA Electronic and Code Sets standardsregulations requiring electronic transactions such as claim transmission to use standardized formats16
3241184872HIPAA Privacy Ruleregulations for protecting individually identifiable information about a patient's health and payment for health care that is created or received by a health care provider17
3241185346HIPAA Security Ruleregulations outlining the minimum administrative, technical and physical safeguards required to prevent unauthorized access to protected health care information18
3241185816National Provider Identifier (NPI)a standard identifier for health care providers consisting of ten numbers19
3241186510personal health records (PHRs)private, secure electronic files that are created, maintained, and owned by the patient20
3241186511physical safeguardsmechanisms required to protect electronic systems, equipment, and data from threats, environmental hazards, and unauthorized intrusion21
3241187070protected health information (PHI)information about a patient's health or payment for health care that can be used to identify the person22
3241187071technical safeguardsautomated processes used to protect data and control access to data23
3241187995walkout statementa document listing changes and payments that is given to a patient after an office visit24
3241187996workflowa set of activities designed to produce a specific outcome25
3241189217X12-837 Health Care Claim (837P)HIPAA standard format for electronic transmission of a professional claim from a provider to a health plan26

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