Exam 16: The Role of Computers in Health Insurance

The process by which claims are submitted directly to the insurance carrier is called:

With the advent of HIPAA,specific federal guidelines are now in place that provide security and protection for all healthcare information transmitted electronically.

To reduce the number of forms and methods of completing claims and other payment-related documents and to use universal identifiers for providers of healthcare are two of the goals of:

______ leads to faster data transfer,fewer errors,instant document retrieval,and less time wasted on exception handling,resulting in a more streamlined communication process.

The acronym for the federal act that amended HIPAA,requiring all Medicare claims to be submitted electronically (except for certain circumstances),is:

Data elements used to uniformly document the reasons why patients are seen and procedures or services provided to them during their healthcare encounters include:

The digital imaging hybrid EMR system provides the best of both worlds- providing easy access of an electronic system but keeping paper records in case of computer problems.

All of the following are necessary for a medical practice to send claims electronically,except:

Both providers and patients want assurances that data transferred electronically does not become vulnerable and fall into the wrong hands.

The electronic computer file that stores patients' health information is called:

To help improve the healthcare administrative process and,at the same time,simplify it,_____ was created.

Sum up the benefits of EDI.

If the goal of a healthcare office is to migrate completely to an EMR system,a ___________ system may be a good choice.

Effective October 2003,HIPAA made it mandatory (with few exceptions)that all Medicare claims be submitted electronically.

A ______________ sorts claims by payer and transmits them to the various insurance companies using the specific formats required by each.

A system wherein data representing money is moved electronically between accounts and organizations is called an EMR.

A type of business that receives insurance claims from multiple medical practices,consolidates them,and transmits them on to various insurance carriers is known as a/an:

The document that allows the provider's office to receive an explanation of benefits electronically is the ____________________.

A "small provider" is a medical facility that has fewer than two practicing physicians.

When a medical practice makes a decision to submit insurance claims electronically to a third-party payer,it must usually first go through a/an: