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Medisoft Terms 1-7
Stack #189795
| Question | Answer |
|---|---|
| policyholder | a person who buys an insurance plan |
| heath plan | a plan or organzation that provides health benefits |
| premium | the periodic amount of money the insured pay to a heath plan for insurance coverage |
| fee for service | health plan that repays the policyholder for covered medical expenses |
| managed care | type of insurance that is responsible for both the financing and the delivery of health care |
| capitation | advance payment to a provider that covers each plan member's health care services for a certain periold of time |
| preferred provider organization | managed care of health care providers who agree to perform services for plan members at discounted fees. |
| back up data3 a copy of data files made at a specific point in time that can be used to restore data to the system | |
| guarantor | an individual who may or may not be a pt of the pratice but who is the insurance policyholder |
| capitated plan | insurance plan in which payments are made to primary care providers whether patients visit the office or not |
| health maintenance organization | type of managed care system in which providers are paid fixed rates at regular intervals |
| explanation of benefits | a paper document from a health plan that lists the amount of a benefit and explains how it was determined |
| clearinghouse | an organization that receives claims from a provider checks and prepares them for precessing and transmits them to insurance carriers in a standardized format |
| information technology | computer hardware and software systems |
| purging data | the process of deleting files of patients who are no longer seen by a provider in a pratice |
| record of treatment and progress | physicians notes about a patients condition and diagnosis |
| adjustments | changes to patients accounts |
| multilinks | groups of procedure code entries that are related to a single activity |
| filter | a condition that data must meet to be selected |
| remittance advice | an electronic document from a health plan that lists the amount of a benefit and explanins how it was determined |
| copayment | a small fixed fee paid by the patient at the time of an office visit |
| practice management program | a software program that automates many of the administrative and financial tasks required to run a medical pratice |
Created by:
aleshamwise
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