CAHIMS - Unit 3|342 Exam Questions And Answers| Success Guaranteed|87 Pages

_____ is the recording of all treatments, diagnoses, and other medical services. It is commonly done electronically but may be done on paper. - ️️charge capture ____ is the process of translating treatments, diagnoses, and other medical services into established alphanumeric codes so that they can be submitted as part of a claim. - ️️coding When a healthcare organization such as a physician group receives a per-head fee for each individual enrolled in a plan, it is known _____. A capitation payment reflects the ____ of its enrollees. A medical service or condition that is exempted from a capitation plan is called a/an _____. If a physician or physician group receives the payment whether or not the individual enrolled in the plan seeks medical services, it represents a ____ mode. - ️️CAPITATION;health status;carve out;CAPITATION A physician organization contracts with a health maintenance organization (HMO) to provide services to its subscribers. The physician organization receives a flat monthly fee for each patient enrolled in the HMO. No additional payments are made for complications or higher-than-expected usage of some healthcare services. This arrangement is known as a _____ fee-for-service bundled service prevention model capitation model - ️️capitation model Provides for continued healthcare coverage after employment is terminated - ️️Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) Limits exclusions based on preexisting conditions; mandates electronic medical records (EMR); mandates privacy requirements for patient information - ️️Health Insurance Portability and Accountability Act (HIPAA)