Questions and Answers
1. Health Insurance Portability and Accountability Act (HIPAA):
protects a patient's personal and medical information including use and disclosure of
personal health information (PHI)
2. personal health information (PHI): Any individually indentifiable health information
such as name, DOB, phone number, address, etc. that is transmitted or maintained by electronic
media such as a computer
3. usual fee: normal fees charged by a provider
4. reasonable fee: fee for service or procedures that require extra time and effort for the
provider due to the level of complexity of the procedure
5. customary fee: a range of fees charged by the providers who have similar training and
experience and practice in the same geographic area
6. capitation: a fixed amount of money paid to a provider by a third-party payer per
individual enrollee for an established period
7. source-oriented: medical record documentation template that is organized by the entity
that supplied the data
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, 8. Stream scheduling: also called time-specified scheduling, is scheduling patients at a
specific time with enough time reserved the visit. The amount of time for each appointment varies
depending on the patient's condi- tion/reason
9. cluster scheduling: scheduling involving grouping patients who have similar conditions into
specific con- ditions into specific time slots or days
10. Wave scheduling: Scheduling three people in the first 30 min of the hour and are
taken to be seen as they arrive. All patient scheduled for that hour are seen with that hour
11. Modified wave scheduling: scheduling patients to arrive at intervals during the
first half of the hour with no patients scheduled during the second half to catch up
12. open hours scheduling: a system of scheduling in which patients arrive at the
doctor's oflce at their convenience and are seen on a first come, first serve basis
13. scheduling all cardiac patients on Mondays and Wednesdays
and oncology patients on Tuesday and Thursday is which type of
scheduling?: cluster
14. what type of appointment system allows flexibility to allow
for the most consistent patient flow?: wave
15. HCPCS codes: service and procedure codes for medicare and are not diagnosis codes
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