CRC final exam study guide Questions
and answers,100% Accurate, Graded A+
Health record (Medical Record) - ✔✔-Written or graphic information documenting the facts and events
during the rendering of patient care.
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...
CRC final exam study guide Questions
and answers,100% Accurate, Graded A+
Health record (Medical Record) - ✔✔-Written or graphic information documenting the facts and events
during the rendering of patient care.
SOAP notes - ✔✔-Office visit notes organized into four sections: Subjective, Objective, Assessment, Plan
EMR - ✔✔-An electronic file wherein patients health information from a single medical provider is
stored in a computer system
EHR - ✔✔-A computerized lifelong healthcare record for and individual that incorporates data from all
providers who treat the individual.
EHR advantages - ✔✔-Accessibility between providers improves quality of care; Cost savings and
increased efficiency; Requires no physical storage; Reduced charting errors; Automatic data capture
Attending physician - ✔✔-Hospital staff member who is legally responsible for care and treatment given
to a patient
Legible documentation requirement - ✔✔-Info in the health record must be easily recognizable by
someone outside of the medical practice who is unfamiliar with the handwriting.
Internal Audits - ✔✔-Audits performed by a staff member of the practice or by a hired consultant to
uncover problems in coding and billing compliance so they can be corrected.
Prospective Review - ✔✔-Review of billing and coding completed BEFORE claims are submitted.
Retrospective Review - ✔✔-Internal review of billing and coding completed AFTER claims are submitted
and after ins co has responded.
Compliance Plan - ✔✔-A medical practice's written policies for complying with payer and government
regulations in order to avoid fraud and abuse.
Collections Specialist - ✔✔-Staff member trained to work with patients to resolve overdue bills.
Financial policy - ✔✔-The medical practice's clear explanation of billing procedures and financial rules,
which should be signed by all patients.
Physician fee schedule - ✔✔-Service fees must be the same for all patients and and a list of common
services, descriptions, and fees must be available to all patients.
Missed appointment fees - ✔✔-Typically $35-50, due from the patient.
Cash patients - ✔✔-A discount may be offered to all patients who pay cash up front (self pays).
Financial hardship discounts - ✔✔-Hardship must be proven and documented, and discounts must be
equally available to all patients based on financial need.
Professional courtesy - ✔✔-The questionable practice of offering reduced or free services to medical
professionals or their families.
The Federal Truth in Lending Act - ✔✔-When interest or finance charges are added to a balance, or if
more than 4 installments are scheduled to pay off a balance, this law requires disclosure forms to be
signed informing the patient of the APR, Finance Charge amount, total financed amount, total of
payments, and payment schedule.
The FDCPA - ✔✔-The Fair Debt Collection Practices Act is a federal law that seeks to eliminate abusive
debt collection practices by debt collectors.
Collection telephone call guidelines - ✔✔-Call between 8am-9pm. One call per day. Follow privacy rules.
Be professional and courteous. Document all calls.
Stay calm.
Collection agency - ✔✔-An outside firm hired to collect on delinquent accounts.
Adjudication - ✔✔-The insurance company's process of examining claims to determine benefits.
Rejected claims - ✔✔-Claims with errors that may be fixed and resubmitted.
Denied claims - ✔✔-Clean claims that the insurance company has determined are not eligible for
payment.
Determination - ✔✔-An insurance company's decision of whether to approve (pay), deny, or downcode
each service billed on the claim.
Remittance advice - ✔✔-Document sent to the provider by the insurance company explaining claim
determination.
Prompt payment laws - ✔✔-State laws that outline how long the payer has to respond to a clean claim.
30 days electronic claims
40 days paper claims - ✔✔-Health insurance claims prompt payment timeframe per NJ Department of
Banking and Insurance
Accounts receivable (A/R) - ✔✔-The department responsible for managing and monitoring account
balances owed to the practice.
Insurance aging report - ✔✔-Report of all balances owed to the practice by insurance companies, sorted
by the length of time the money has
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