Organizations
Non-profit organization whose focus is on improving healthcare quality and patient safety
What is The Joint Commission?
Technical Standard for digital storage and transmission of medical images
What is DICOM (digital imaging communication system)
document sent to patient that contains allowed amount, reimbursed amount pt. responsibility
What is the EOB (explanation of benefits)?
Form that includes if patient has an MPOA, living will, DNR, Healthcare proxy, organ donor
What is the advanced directives?
prohibits physicians from referring if they have a financial relationship with the company
What is the Stark Law
HHS and agency responsible for protecting public health and safety
What is CDC (Centers for Disease Control and Prevention)?
Manages laboratory workflows, specimen tracking and test results
What is LIS (laboratory information system)
document sent to provider shows the allowed amount, reimbursed amount and pt. responsibility
What is the RA (remittance advice)?
Form that provided patient how the provider will keep the patient information private and confidential.
NPP (notice of privacy practices)
Prohibits providers from receiving anything of value for referring services
What is the Anti-Kickback law?
Federal agency that plays a vital role in ensuring access to quality healthcare
What is CMS (Centers for Medicaid and Medicare Services)
enables the digital management of medical imaging, captures, stores and transmits imaging
What is PACS (picture archiving communication system)
itemized form that details the services provided to the patient. Can be used during downtime
What is a Superbill, encounter form, charge slip?
Form that allows payment to go directly to the provider for services rendered
What is the AOB (advanced beneficiary form)?
Legally required contract that ensures HIPAA compliance
What is a business associate agreement
Federal Agency that investigates and detecting fraud, waste and abuse
what is the OIG (Office of Inspector General)?
designed to assist coders by analyzing clinical documentation and suggest Dx, CPT codes
What is CAC (computer assisted coding)?
E1490
What is a HCPCS (health care common procedure coding system)
Form given to Medicare recipient if a service is denied they will accept whole cost
What is the ABN (advanced beneficiary notice).
Federal Law that created the Quality Payment Program for MCR to tie payments to quality and value
What is MACRA
Federal agency that enforces civil rights laws and investigates HIPPA violations
What is the OCR (Office of Civil Rights)?
tools that helps providers with better clinical decisions, suggests treatment options or dosages
What is CDSS (clinical decision support system)
99204
What is an example of a CPT code?
Form that requires 4 elements signature date, expiration date, purpose and info to be released
What is the ROI (release of information) form?
Law that protects the privacy and security of an individuals medical information
What is HIPAA?