NHA - Certified Medical Administrative Assistant (CMAA) Study Guide AVTEC Already Passed

NHA - Certified Medical Administrative Assistant (CMAA) Study Guide AVTEC Already Passed Computer Scheduling ✔✔Electronic appointment book Book Scheduling ✔✔Hard copy appointment book Wave Booking ✔✔Patients are sch ...

NHA - Certified Medical Administrative Assistant (CMAA) Study Guide AVTEC Already Passed Computer Scheduling ✔✔Electronic appointment book Book Scheduling ✔✔Hard copy appointment book Wave Booking ✔✔Patients are scheduled at the same time each hour to create short-term flexibility each hour. Modified Wave Booking ✔✔Wave booking can be modified in a couple of different ways. One example of this approach is to schedule two patients to come at 9 a.m. and one patient at 9:30 a.m. This hourly cycle is repeated throughout the day. Double Booking ✔✔Two patients are scheduled to come at the same time to see the same physician. Stream/time-Specific Scheduling ✔✔Scheduling patients for specific times at regular intervals. The amount of time allotted depends on the reason for the visit. Open Booking (tidal wave scheduling) ✔✔Patients are not scheduled for a specific time, but told to come in at intermittent times. They are seen in the order in which the arrive. Cluster or Categorization Booking ✔✔Booking a number of patients who have specific needs together at the same time of day. Matrix ✔✔A grid with time slots blocked out when physicians are unavailable or the office is closed. Template ✔✔A document with a preset format that is used as a starting point so that it does not have e recreated each time. Screening System ✔✔Procedures to prioritize the urgency of a call to determine when the patient should be seen. Certified Mail ✔✔First-class mail that also gives the mail added protection by offering insurance, tracking, and return receipt options. Appointment Cards ✔✔Used to remind patients of scheduled appointments and to eliminate misunderstandings about dates and time. Health Insurance Portability and Accountability Act (HIPAA) of 1996 ✔✔Legislation that includes Title II, the first parameters designed to protect the privacy and security of patient information. What are three advantages of computer scheduling? ✔✔Display available and scheduled times; length and type of appointment required and day or time preferences. When scheduling appointments, what factors need to be taken into account? ✔✔The needs of the patient, the habits and preferences of the provider, and the capacity of the facility. Electronic Medical Record (EMR) ✔✔An electronic record of health information that is created, added to, managed, and reviewed by authorized providers and staff within a single health care organization. Advance Directive Form ✔✔Document that spells out what kind of treatment a patient wants in the event that he can't speak for himself. Also known as living will. Protected Health Information (PHI) ✔✔Information about health status or health care that can be linked to a specific individual. What are three types of demographics? ✔✔Name, address, and marital status. Health Insurance ✔✔Financial support for medical needs, hospitalization, medically necessary diagnostic tests and procedures, and may kinds of preventive services. Electronic Health Record (EHR) ✔✔An electronic health record of health-related information about a patient that conforms to nationally recognized interoperability standards that can be created, managed, and reviewed by authorized providers and staff from more than one health care organization. Co payment ✔✔Fees collected from patient at the time of services. Guarantor ✔✔Person or entity responsible for the remaining payment of services after insurance has paid. Birthday Rule ✔✔The health plan of the parent whose birthday comes first in the calendar year is designated as the primary plan. Healthcare Common Procedure Coding System (HCPCS) ✔✔A group of codes and descriptors used to represent health care procedures, supplies, products, and services. Reimbursement ✔✔Payment from insurance companies. International Classification of Diseases, ICD-9-CM and/or ICD-10-CM ✔✔Track a patient's diagnosis and clinical history. Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) ✔✔Are used to report provider services for the purpose of reimbursement. Medicare ✔✔Federally funded health insurance provided to people age 65 or older, people younger than 65 who have certain disabilities, and people of all ages with end-stage kidney disease. Modifiers ✔✔Added information or changed description of procedures and services, and are a part of valid CPT or HCPCS codes. Health History ✔✔Form that asks patients to list any illnesses or surgeries they have had, family history, medications taken, chronic health issues, allergies, and other physicians they consulted. Notice of Privacy Practices ✔✔Document informing a patient of when and how their PHI can be used. Consent ✔✔A patient's permission Patient Financial Responsibility form ✔✔Form that confirms that the patient is responsible for payments to the provider. Assignment of benefits (AOB) form ✔✔Form that authorizes health insurance benefits to be sent directly to providers. Living Will ✔✔Document that spells out what kind of treatment a patient wants in the even that he can't speak for himself. Also know as advance directive. DNR Form ✔✔Form that states that the patient does not want to be revived after experience a heart episode or other kind of life-threatening event. Encounter Form ✔✔A document used to collect data about elements of a patient visit that can become part of a patient record or be used for management purposes. Regular Referral ✔✔When a physician decides that a patient needs to see a specialist. Urgent Referral ✔✔When and urgent, but not life-threatening, situation occurs, requiring that the referral be taken care of quickly. STAT Referral ✔✔Needed in an emergency situation, and can be approved immediately over the telephone after the utilization review has approved the faxed document. Active Files ✔✔Section of medical charts for patients currently receiving treatment. Inactive Files ✔✔Section of medical charts for patients the provider has not seen for 6 months or longer. Closed Files ✔✔Section of medical charts for patients who have died, moved away, or terminated their relationship with the physician. Purging ✔✔The process of moving a file from active to inactive status Provisional Diagnosis ✔✔A temporary or working diagnosis. Differential Diagnosis ✔✔The process of weighing the probability that other diseases are the cause of the problem. Direct Filing System ✔✔System in which the only information needed for filing and retrieval is a patient's name. Cross-reference ✔✔Reference to corresponding information in a separate location. Privacy Rule ✔✔A HIPAA rule that establishes protections for the privacy of individual's health information. Individually Identifiable Health Information ✔✔Documents or bits of information that identify the person or provide enough information so that the person could be identified. Bookkeeping ✔✔Part of the office's accounting functions, to include recording, classifying, and summarizing financial transactions. Copayment ✔✔A fixed fee for a service or medication, usually collected at the time of service or purchase. Deductible ✔✔The amount a patient must pay before insurance pays anything. Coinsurance ✔✔A form of cost sharing the kicks in after the deductible has been met. Statement ✔✔A request for payment. Explanation of Benefits (EOB) ✔✔A record of a patient's fees. Accounts Receivable Ledger ✔✔Document that provides detailed information about charges, payments, and remaining amounts owed to a provider. Fee-for-service ✔✔Model in which providers set the fees for procedures and services. Allowable Amount ✔✔The limit that most insurance plans put on the amount that will be allowed for reimbursement for a service or procedure. Resource-based Relative Value Scale (RBRVS) ✔✔System that provides national uniform payments after adjustments across all practices throughout the country. Medicare Part B ✔✔Voluntary supplemental medical insurance to help pay for physicians' and other medical professionals' services, medical services, and medical-surgical supplies not covered by Medicare Part A. Petty Cash Fund ✔✔A small amount of cash available for expenses such as postage, parking fees, small contributions, emergency supplies, and miscellaneous small items. Disbursement ✔✔The record of the funds distributed to specific expense accounts. Daily Journal ✔✔A chronological record of bills received, bills paid, and payments and reimbursements received. Day Sheet ✔✔A daily record of financial transactions and services rendered. End-of-day Summary ✔✔Document consisting of proof of posting sections, month-to-date accounts receivable proof, and year-to-date accounts receivable proof. Single-entry System ✔✔A method of bookkeeping that relies on a one-sided accounting entry to maintain financial information. General Journal ✔✔Document where transactions are entered. Double-entry bookkeeping ✔✔A system in which every entry to an account requires an opposite entry to a different account. Subsidiary Journals ✔✔A document where transactions are summarized and later recorded in a general ledger. Invoice ✔✔A document that describes items purchased or services rendered and shows the amount due. Assets ✔✔The properties owned by a business. Equities ✔✔What is left of assets after creditors' liabilities have been subtracted. Liabilities ✔✔The equity of those to whom money is owed (creditors). First-class Mail ✔✔Sealed or unsealed typed or handwritten material, including letters, postal cards, postcards, and business reply mail. Priority Mail ✔✔First-class mail weighing more than 13 ounces. Standard Mail ✔✔Mail that includes advertising, promotional, directory, or editorial material, or any combination of such material. Insured Mail ✔✔Mail that has insurance coverage against loss or damage. Registered Mail ✔✔Mail of all classes protected by registering and requesting evidence of its delivery. Packing Slip ✔✔A list of items in a package. Terminal Numbering System ✔✔Assigning consecutive numbers to patients while separating the digits in the number into groups of twos or threes.