Chapter #1 Key terms in PPC's Medical Office Software with Connie(Nights).Book's titled,"Computers in the Medical Office 6th edition".
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| 3480865296 | Accounting Cycle | Flow of financial transactions in a business. | 0 | |
| 3480865297 | Accounts Receivable(AR) | Monies that are flowing IN to a business. | 1 | |
| 3480865298 | Adjudication | Series of steps that determine whether a claim should be paid. | 2 | |
| 3480865299 | Billing Cycle | Regular schedule of sending statements to patients. | 3 | |
| 3480865300 | Capitation | Advance payment to a provider that covers each plan member's health care services for a certain period of time. | 4 | |
| 3480865301 | Coding | Process of assigning standarized codes to diagnoses and procedures. | 5 | |
| 3480865302 | Coinsurance | Part of charges that an insured person must pay for health care services after payment of the deductible amount. | 6 | |
| 3480865303 | Consumer-driven health plan(CDHP) | A type of managed care in which a high-deductible/low-premium insurance plan is combined with a pretax savings account to cover out-of-pocket medical expenses, up to the deductible amount. | 7 | |
| 3480865304 | Copayment | A small fixed fee paid by the Pt at time of office visit. | 8 | |
| 3480865305 | Diagnosis | Physician's opinion of nature of Pt's illness or injury. | 9 | |
| 3480865306 | Diagnosis Code | Standarized value that represents a Pt's illness, signs, symptoms. | 10 | |
| 3480865307 | Encounter Form | List of procedures and charges for a Pt's visit. | 11 | |
| 3480865308 | Explanation of Benefits(EOB) | Paper document from a payer that shows how amount of a benefit was determined. | 12 | |
| 3480865309 | Fee-for-service | Health plan that repays policyholder for covered medical expenses. | 13 | |
| 3480865310 | Health Maintenance Organization(HMO) | Managed health casre system in which providers agree to offer health care to the organization's members for fixed periodic payments from the plan. | 14 | |
| 3480865311 | Health Plan | Plan, program, or organization that provides health benefits. | 15 | |
| 3480865312 | Managed Care | Type of insurance in which carrier is responsible for both the financing and delivry of health care. | 16 | |
| 3480865313 | Medical Coder | Person who analyzes and codes Pt diagnoses, procedures, and symptoms. | 17 | |
| 3480865314 | Medical Necessity | Tx provided by a physician to a Pt for purpose of preventing, diagnising, or treating an illness, injury, or its symptoms in a manner that's appropriate and provided in accordance w/ generally accepted standards of med. prac. | 18 | |
| 3480865315 | Modifier | A two-digit character that's appended to a CPT code to report special circumstances involved w/a procedure or service. | 19 | |
| 3480865316 | Patient Information Form | Form that includes a Pt's personal, employment, and insurance data needed to complete an insurance claim. | 20 | |
| 3480865317 | Payer | Private or government org that insures or pays for health care on behalf of beneficiaries. | 21 | |
| 3480865318 | Policyholder | Person who buys an insurance plan; the insured. | 22 | |
| 3480865319 | Practice Management Program(PMP) | Software program that automates many of the administrative and financial tasks required to run a medical practice. | 23 | |
| 3480865320 | Preferred Provider Organization(PPO) | Managed care network of health care providers who agree to preform services for plan members at discounted fees. | 24 | |
| 3480865321 | Premium | Periodic amount of money the insured pays to a health plan for insurance coverage. | 25 | |
| 3480865322 | Procedure | Medical treatment provided by a physician or other health care provider. | 26 | |
| 3480865323 | Procedure Code | Code that identifies a medical service. | 27 | |
| 3480865324 | Remittance Advice(RA) | An explanation of benefits transmitted electronically by a payer to a provider. | 28 | |
| 3480865325 | Statement | A list of all services preformed for a Pt, along w/ charges for each service. | 29 | |
| 3480865326 | Steps of Billing Process | 1.Preregister Pt 2.Establish financial responsibilty 3.Check in Pt 4.Check out Pt 5.Review Coding compliance 6.Check billing compliance 7.Prepare and transmit claims 8.Moniter payer adjudication 9.Generate Pt statements 10. Follow up payments and collections | 30 |
