Acronyms & Abbreviations
ED
What is Emergency Department?
A statement of the health services provided to a patient during a specific episode of care.
Submitted by a provider to a third-party payer
What is Claim?
The field of study that deals with moral principles, theories, & values. What is 'right' in a professional setting.
What is Ethics?
Using the record for documentation of care provided to the patient is said to be this type of Purpose of the record.
What is a Primary Purpose?
EHR is the acronym that stands for this
What is Electronic Health Record?
HIE
What is Health Information Exchange
Payment to a healthcare provider in exchange for services rendered.
What is Reimbursement?
A system of principles with regard to right or wrong. A person's own set of values.
What are Moral Values?
These users of the health record:
Patient care providers, Coding staff, Patients, Employers, Lawyers, Law Enforcement officials, Researchers
What are Individual Users?
Data that have been processed into meaningful form to make them valuable to the user and converted into a form that can be used for a specific purpose.
It represents meaning
RHIA
What is Registered Health Information Administrator?
Determining which insurance coverage is the primary, secondary and tertiary payer
What is Cordination of Benefits?
The perceived or actual difference among people.
What is Diversity?
These types of users of the health record:
Healthcare delivery organizations
Third-party payers
Research organizations
Government licensing agencies
Policy-making bodies
What are Institutional Users?
One patient record for two different patients vs. two record numbers for the same patient is the difference between these two
What is Overlay and Overlap?
ICD-10-CM
A list that contains every service and supply the facility provides and the charge for that service
What is Charge Description Master (CDM)?
What is Altruism?
Legally disclosing patient-identifiable information is called this
What is Release of Information
In paper record filing, this is a space holder for the record. It is usually colored vinyl, pocket folder inserted in place of the paper record.
What is an Outguide?
CAHIIM
The determination that the services will benefit the patient and are needed.
What is Medical Necessity?
A patient's right to chose their own course of treatment.
What is Autonomy?
Where a permanent record of all patients treated at the healthcare organization is kept in electronic form. Includes demographics, and patient record numbers only; no clinical information
What is the Master Patient Index (MPI)?
The legal and ethical concept that requires healthcare providers to protect health records and other personal and private information from unauthorized use or disclosure.
Confidentiality