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Mode 4010 wk 2
4010 2Terms and Abbreviations
| Question | Answer |
|---|---|
| ASP | Application Service Provider |
| DDE | Direct Data Entry |
| DSL | Digital Subscriber Line |
| EDI | Electronic Data Interchange |
| EFT | Electronic Funds Transfer |
| EIN | Employer Identification Number |
| ERA | Electronic Remittance Advice |
| ICD-10 CM | International Classification of Diseases Tenth Revision, Clinical Modification |
| ICD-9 CM | International Classification of Diseases Ninth Revision, Clinical Modification |
| NEC | Not Elsewhere Classifiable |
| NOS | Not Otherwise Specified |
| NPI | National Provider Identifier (number) |
| NSF | National Standard Format |
| PHI | Protected Health Information |
| PMS | Practice Management System |
| Clearinghouse | An independent organization that receives insurance claims from the physician's office, performs software edits, and redistributes the claims electronically to various insurance carriers. |
| Code sets | any set of codes with their descriptions used to encode data elements such as tables of terms, medical concepts, medical diagnostic codes, or medical procedure codes |
| Covered entity | an entity that transmits health information in electronic form in connection with a transaction covered by HIPPA |
| Data elements | medical code sets used uniformly to document why patients are seen and what is done to them during their encounter |
| Digital subscriber line | A high-speed connection through a telephone line jack and usually a means of accessing the Internet |
| Direct data entry | Keying claim information directly into the payer system by accessing over modem dial-up or DSL |
| Electronic Data interchange | the process by which understandable data items are sent back and forth via computer linkages between tow or more entities that function alternatively as sender and receiver |
| Electronic funds transfer | is a paperless computerized system that enables funds to be debited, credited, or transferred and eliminates the need for personal handling of checks |
| Electronic Remittance Advise | An online transaction about the status of a claim |
| Encryption | is used to assign a code to represent data |
| HIPAA Transaction and Code Set Rule | was developed to introduce efficiencies into the health care system/ this regulation under HIPAA defines the standardized methods for transmitting electronic health information |
| National standard format | The name of the standardization of data to reduce paper and have more accurate information and efficient organization |
| Real time | Online interactive communication between two computer systems allowing instant transfer of information |
| Trading partner agreement | Contract between the provider and a clearinghouse that submits the electronic claims on behalf of the provider |
| Medical Necessity | The performance of services and procedures that are consistent with the diagnosis in accordance with standards of good medical practice performed at proper level, and provided in the most appropriate setting |
| Root word | The word used to look up the code correctly the first time, meaning the condition, for the ICD-9 disease, sign, symptom, the key word to the problem |
| Chronic | A medical condition persisting over a long period of time |
| Acute | A medical condition that runs a short but relatively severe course |
| Encoder | Add-on software to practice management systems that can reduce the time it takes to build or review insurance claims before batch transmission to the carrier |
Created by:
SSchabow
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