CRC final exam study guide Questions and answers,100% Accurate, Graded A+

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CRC final exam study guide Questions and answers,100% Accurate, Graded A+ Health record (Medical Record) - ✔✔-Written or graphic information documenting the facts and events during the render... ing of patient care. SOAP notes - ✔✔-Office visit notes organized into four sections: Subjective, Objective, Assessment, Plan EMR - ✔✔-An electronic file wherein patients health information from a single medical provider is stored in a computer system EHR - ✔✔-A computerized lifelong healthcare record for and individual that incorporates data from all providers who treat the individual. EHR advantages - ✔✔-Accessibility between providers improves quality of care; Cost savings and increased efficiency; Requires no physical storage; Reduced charting errors; Automatic data capture Attending physician - ✔✔-Hospital staff member who is legally responsible for care and treatment given to a patient Legible documentation requirement - ✔✔-Info in the health record must be easily recognizable by someone outside of the medical practice who is unfamiliar with the handwriting. Internal Audits - ✔✔-Audits performed by a staff member of the practice or by a hired consultant to uncover problems in coding and billing compliance so they can be corrected. Prospective Review - ✔✔-Review of billing and coding completed BEFORE claims are submitted. Retrospective Review - ✔✔-Internal review of billing and coding completed AFTER claims are submitted and after ins co has responded. Compliance Plan - ✔✔-A medical practice's written policies for complying with payer and government regulations in order to avoid fraud and abuse. Collections Specialist - ✔✔-Staff member trained to work with patients to resolve overdue bills. Financial policy - ✔✔-The medical practice's clear explanation of billing procedures and financial rules, which should be signed by all patients. Physician fee schedule - ✔✔-Service fees must be the same for all patients and and a list of common services, descriptions, and fees must be available to all patients. Missed appointment fees - ✔✔-Typically $35-50, due from the patient. Cash patients - ✔✔-A discount may be offered to all patients who pay cash up front (self pays). Financial hardship discounts - ✔✔-Hardship must be proven and documented, and discounts must be equally available to all patients based on financial need. Professional courtesy - ✔✔-The questionable practice of offering reduced or free services to medical professionals or their families. The Federal Truth in Lending Act - ✔✔-When interest or finance charges are added to a balance, or if more than 4 installments are scheduled to pay off a balance, this law requires disclosure forms to be signed informing the patient of the APR, Finance Charge amount, total financed amount, total of payments, and payment schedule. The FDCPA - ✔✔-The Fair Debt Collection Practices Act is a federal law that seeks to eliminate abusive debt collection practices by debt collectors. Collection telephone call guidelines - ✔✔-Call between 8am-9pm. One call per day. Follow privacy rules. Be professional and courteous. Document all calls. Stay calm. Collection agency - ✔✔-An outside firm hired to collect on delinquent accounts. Adjudication - ✔✔-The insurance company's process of examining claims to determine benefits. Rejected claims - ✔✔-Claims with errors that may be fixed and resubmitted. Denied claims - ✔✔-Clean claims that the insurance company has determined are not eligible for payment. Determination - ✔✔-An insurance company's decision of whether to approve (pay), deny, or downcode each service billed on the claim. Remittance advice - ✔✔-Document sent to the provider by the insurance company explaining claim determination. Prompt payment laws - ✔✔-State laws that outline how long the payer has to respond to a clean claim. 30 days electronic claims 40 days paper claims - ✔✔-Health insurance claims prompt payment timeframe per NJ Department of Banking and Insurance Accounts receivable (A/R) - ✔✔-The department responsible for managing and monitoring account balances owed to the practice. Insurance aging report - ✔✔-Report of all balances owed to the practice by insurance companies, sorted by the length of time the money has [Show More]

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