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What does "HCPCS" stand for?
Healthcare common procedure coding system.
How many years does it take after not seeing a patient to be considered a "new patient"
3 years or longer
What does the administrative section include? (3 examples)
Pateint information (name, DOB, phone number)
allergies
consent forms
The amount that must be paid before benefits are paid by the insurance company
Deductible
what is the purpose of reconciling patients financial records?
ensures accounts are balanced and accurate. and recorded to the correct patient
What are 3 examples of current procedural terminology
Office visits, laboratory tests, lession removal
How much time does the new patient appointment take?
60 minutes
What is the purpose of the patient flow sheet
Tracks patient visits or lab results
Approval of insurance coverage and necessity of services prior to the patient receiving them
Preauthorization
what is the first thing in the revenue cycle?
registration and scheduling
What are the code identifies for HCPCS?
Supplies, procedures, services
Which appointment saves patients money and time by avoiding travel time or transportation challenges?
telehealth (virtual)
What does AVS stand for
after-visit summary
What is copayment?
A set amount determined by the plan/payer that the patient pays for specified services, usually office visits and emergency department visits
what is the last in the revenue cycle
patient collection and payments posting
ICD-10-PCS are only for which kind of patient
inpatient only
How many minutes early does the MA ask the patient to come in to fill out paperwork?
15 minutes
A record of the diagnosis and procedures covered during the current visit, also known as superbill
encounter form
What are the three requirements needed for optimum reimbursement?
Verify eligibility
verify if the patient's insurance covered the proposed service
complete insurance's requirements for obtaining authorization to provide the service to the patient
What does the revenue cycle do?
verifies patient eligibility to the final step of ensuring the appropriate reimbursement.
Which code set is used for billing professional services?
current procedural terminology (CPT)
What is clustering?
Patients are scheduled in groups with common medical needs.
Define Notice of Privacy Practices (NPP)
A document that identifies how the provider will distribute and disclose a patient's protected health information.
What are the four patients' financial responsibility
Premium, deductible, coinsurance, and copay
What makes the revenue cycle effective?
Organization, the patient records, documentation, coding and billing, claim submission, payment posting, and follow-ups.