Basic Health Insurance Vocab. Words. Chap 2

Front 1

ABUSE

Back 1

Actions that improperly use another person's resources

Front 2

AUDIT

Back 2

A formanl examination of a physician's accounting or patient medical records

Front 3

AUTHORIZATION

Back 3

Document signed by a patient that permits the release of particular medical information under specific stated conditions

Front 4

BUSINESS ASSOCIATE

Back 4

A person or organization that performs a function or activity for a covered entity but is not part of its work force

Front 5

(CMS) CENTERS FOR MEDICARE AND MEDICAID SERVICES

Back 5

Federal agency within the Department of Health and Human Services (HHS) that runs medicare, medicaid, clinical laboratories and other government health programs

Front 6

CHIEF COMPLAINT (CC)

Back 6

A patients description of the symptoms or other reasons for seeking medical care from a provider

Front 7

CLEARINGHOUSE

Back 7

A company that converts, for a fee, nonstandard data formats into HIPAA standard transactions and transmits the data to health palns; or also handles the reverse process, changing the HIPAA formatted transactions from health plans into nonstandard formats for providers

Front 8

CODE SET

Back 8

Alphabetic and/or numeric representations for data

Front 9

COVERED ENTITY
(CE)

Back 9

Under HIPAA, a health plan, clearinghouse, or provider that transmits any health information in electronic form in connection with a HIPAA transaction

Front 10

DE-IDENTIFIED HEALTH INFORMATION

Back 10

Medical data from which individual identifiers have been removed; also known as a redacted or blinded record

Front 11

DESIGNATED RECORD SET
(DRS)

Back 11

A covered entity's records that contain Protected Health Information (PHI)

Front 12

DOCUMENTATION

Back 12

The systematic, logical, and consistent recording of a patient's health status, history, examinations, tests, results of treatment and observations- in chronological order in a patient medical record

Front 13

ELECTRONIC MEDICAL RECORD
(EMR)

Back 13

Creation and/ or maintenance of a patient medical records in electronic form, such as computer files

Front 14

ENCOUNTER

Back 14

An office visit between a patient and a medical professional

Front 15

EVALUATION ANS MANAGEMENT
(E/M )

Back 15

Procedure codes that cover physicians' services performed to determine that optimum course for a patients care.
(listed in the E/M section of the CPT)