NHA CCMA Administrative Assisting Review Study Guide with Complete Solutions

NHA CCMA Administrative Assisting Review Study Guide with Complete Solutions Health Insurance Portability and Accountability Act (HIPAA) - Answer️️ -protects a patient's personal and medical information including use and disclosure of personal health information (PHI) personal health information (PHI) - Answer️️ -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 usual fee - Answer️️ -normal fees charged by a provider reasonable fee - Answer️️ -fee for service or procedures that require extra time and effort for the provider due to the level of complexity of the procedure customary fee - Answer️️ -a range of fees charged by the providers who have similar training and experience and practice in the same geographic area capitation - Answer️️ -a fixed amount of money paid to a provider by a third-party payer per individual enrollee for an established period source-oriented - Answer️️ -medical record documentation template that is organized by the entity that supplied the data ©SOPHIABENNETT@ Monday, August 26, 2024 6:09 AM 2 Stream scheduling - Answer️️ -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 condition/reason cluster scheduling - Answer️️ -scheduling involving grouping patients who have similar conditions into specific conditions into specific time slots or days Wave scheduling - Answer️️ -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 Modified wave scheduling - Answer️️ -scheduling patients to arrive at intervals during the first half of the hour with no patients scheduled during the second half to catch up open hours scheduling - Answer️️ -a system of scheduling in which patients arrive at the doctor's office at their convenience and are seen on a first come, first serve basis scheduling all cardiac patients on Mondays and Wednesdays and oncology patients on Tuesday and Thursday is which type of scheduling? - Answer️️ -cluster what type of appointment system allows flexibility to allow for the most consistent patient flow? - Answer️️ -wave ©SOPHIABENNETT@ Monday, August 26, 2024 6:09 AM 3 HCPCS codes - Answer️️ -service and procedure codes for medicare and are not diagnosis codes bundled codes - Answer️️ -codes used to group together one or more procedures or services that are billed as one procedure or service multiple coding - Answer️️ -reporting several codes to fully describe the condition; used for diagnosis coding Modifers - Answer️️ -Added information or changed description of procedures and services, and are a part of valid CPT or HCPCS codes. Coding to the Highest Level of Specificity - Answer️️ -this kind of coding ensures the third-party payer is receiving the most specific diagnostic code. This coding avoids an insurance denial. Accountable Care Organization (ACO) - Answer️️ -An organization of healthcare providers accountable for the quality, cost, and overall care of Medicare beneficiaries who are assigned and enrolled in the traditional fee- for-service program medicare - Answer️️ -A federal program of health insurance for persons 65 years of age and older American Red Cross - Answer️️ -a community service organization that provides general assistance during emergencies and times of c