Exam 8: The Electronic Claim

A/an __ is a preprinted document used by the provider to circle procedural and diagnostic codes that are then passed on to the insurance billing specialist and used to enter information into the computer system.

Medicaid, Medicare, and TRICARE use which system to eliminate the need for a clearinghouse?

List the three ways in which clearinghouses are paid.

The HIPAA Security Rule addresses security of electronic PHI in which area?

Match the frequency with which each of the procedures described below should be done with the word correctly describing that frequency. -Research unpaid claims.

Health care providers were required to comply with electronic fund transfer rules by January 1, 2014.

Data that is made unintelligible to unauthorized parties is referred to as

A digital subscriber line (DSL) is a high-speed connection used for data transmission that is accessed through a ____.

The exchange of data in a standardized format through computer systems is known as electronic data interchange.

The most important function of a practice management system is coding of claims for submission.

What does an electronic remittance advice (RA) do?

Match the frequency with which each of the procedures described below should be done with the word correctly describing that frequency. -Review all claim rejection reports.

Once a clearinghouse receives an electronic claims transmission, the first step is for claims to go through an editing process in which the claim is ___ for missing or incorrect information.

An online transaction concerning the status of an insurance claim is called a/an ___.

A transmission report which identifies the most common reasons for claim denial is the

Name three advantages of using a clearinghouse to bill insurance companies.

One advantage of electronic claim submission is the ability to build a/an ____ which provides a chronologic record of submitted data that can be traced to the source to determine the place of origin.

For insurance claims to be submitted electronically, a signed agreement by the physician with the carriers involved is necessary.

List three additional names for an encounter form.

The most common type of physical access control to limit access to areas where medical charts are kept is