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HIT Chapter 5 Vocabulary

QuestionAnswer
Abstract pull out information from the health record or the encounter form that is needed to complete the CMS-1500 claim form
ASCII most common format used for text files in computers and on the internet
Assign benefits authorizes the insurance company to send the payment directly to the healthcare professional
Beneficiary individuals covered under Medicare
Claims clearinghouse a company that receives claims from healthcare providers and specializes in consolidating the claims to send in one transmission to each third party payer containing batches of claims
Clean claims Claims that can be processed for payment quickly without being returned or held for additional information
CMS-1500 form standard insurance form used by all government and most commercial insurance payers
Demographic information patient name, address, SSN, and employment date
Encounter Form multipurpose billing form that can be customized to medical specialties and preprinted with common diagnoses and procedures for that particular specialty
Mono-spaced fonts each character takes up exactly the same amount of space
OCR scannable documents formatted and printed in a way that they can be read using the process of optical character recognition
OCR recognition of printed or written text characters by a computer
Patient ledger card used to manually track patient charges and payments
Release of information used to assign benefits for Medicare patients; referred to as a “lifetime” release of information
Small provider a provider of services with fewer than 25 full time employees or a physician. Practioner, facility, or supplier(other than the provider of services) with fewer than 10 full time employees
Waiver when the Secretary formally tells a provider that he or she does not have to send Medicare claims electronically
Created by: Alyshia
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