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32 Cards in this Set
- Front
- Back
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accounting cycle
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the flow of financial transactions in a business
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accounts receivable
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term used to describe money coming into a business
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capitatioin
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a fixed amount that is paid to a provider in advance
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coinsurance
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part of charges that an insured person must pay for health car services after payment of the deductible amount.
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copayment
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a small fixed fee payed by the patient at the time of the office visit.
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diagnosis code
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a value that stands for a patients illness signs or symptoms
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encounter form
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a form listing procedures relevant to the specialty of a medical office, used to record the procedures
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explanation of benefits
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a paper document from a health plan that lists the amount of a benefit and explains how it was determined
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fee-for-service
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an insurance plan inwhich plicy holders are reimburesed for health care costs.
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procedure code
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a number that represents medical procedures performed by a provider
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remittance advice
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an electronic document from a health plan tha tlists the amount of a benefit and explains how it was determined
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health maintenance organization
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a type of managed care system in which providers are paid fixed rates at regular intervals
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health plan
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a plan, program, or organization that provides health benefits
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managed care
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a type of insurance in which the carrier is responsible for the financing and delivery of health care
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patient information form
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a document that contains personal employment, and medical insurance information about a patient
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payer
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private or government organization that insures or pays ofr health care
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policy holder
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an individual who has contracted with a health plan for coverage
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ppo preferred provider organization
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a network of health care providers who agree to provide services to plan memebers at a discounted fee
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premium
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a payment made to a health plan by a policy holder for coverage
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audit/edit report
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a report that lists errors in a claim
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protected health information
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information about a patients past, present or future physical or mental health or payment for health care that can be used to identify the person
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clearinghouse
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an organization that receives claims from a provider, checks and prepares them for processing, and trasmits them to insurance carriers in a standardized format.
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electronic prescribing
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the use of computers and handheld devices to write and transmit prescriptions to a pharmacy in a secure digital format
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national provider number
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a national standard identifier for all health care providers consisting of ten numbers
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electronic data interchange (edi)
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the transfer of business transactions from one computer to another using communications protocols
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practice management program (pmp)
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a software program that automates many of the administrative and financial tasks required to run a medical practice
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electronic medical records (emr)
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the electronic collections and mangement of health information
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hipaa security rule
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regulations outlining the minmum safeguards required to prevent unauthorized access to electronic health care information
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information technology
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computer hardware and software systems
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walkoiut statement
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a document listing charges and payments that is given to a patient after an office visit
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x12-837 health care claim
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hipaa standard format for electronic transmission of a professional claim from a procider to a health plan.
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hipaa electronic transaction and code sets standards
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regulations that require lectronic transactions to use standardized formats
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