NHA Billing & Coding Study Guide.
Approved Comprehension. Rated A+
Must be included when billing an insurance company: - Ans-DOS, POS, TOS, and dx or DX
DOS - Ans-Date of Service
POS - Ans-Place of service
TOS - Ans-type of service
DX or dx - Ans-diagnosis
HIPAA - Ans-under what rule mays use patients Protected Health Information (PHI) with out specific
authorization for treatment, payment, and operation purposes (TPO).
T in TPO? - Ans-treatment
P in TPO? - Ans-Payment
O in TPO? - Ans-Operations
What does (T)reatment in TPO mean? - Ans-primarily for the purpose of discussion of the patients
case with other providers
What does (P)ayment in TPO mean? - Ans-where providers submit claims on behalf of patients
What does (O)perations in TPO mean? - Ans-for purposes such as staff training and quality
improvement
, Employer Liability - Ans-physicians are legally responsible for their own conduct and any actions of
their employees.
Employee Liability - Ans-"errors and omissions insurance" a protection against a loss of monies
caused by failure through error or unintentional omission on the part of the individual or service
submitting the insurance claim
Let the master answer - Ans-means an employee can be sued and brought to trial
Medical Record - Ans-: documentation on the patients social and medical history, family history,
physical examination findings, progress notes, radiology and lab results, consultation reports and
correspondence to patient
Reason 1 for Documentation of Pt Records - Ans-avoiding denied payments by insurance carriers
investigating the medical necessity of services
Reason 2 for Documentation of Pt Records - Ans-enforcement of record keeping rules by insurance
carriers requiring accurate documentation that supports procedure and diagnostic codes
Reason 2 for Documenting of Pt Records - Ans-Subpoena of medical records by state investigators of
the court review
Reason 4 for Documenting of Pt Records - Ans-Defense of a professional liability claim
Indefinitely - Ans-a M.D. must keep living Pt records for
5 years - Ans-a MD must keep deceased Pt records for
pain - Ans--algia
blood condition - Ans--emia
Approved Comprehension. Rated A+
Must be included when billing an insurance company: - Ans-DOS, POS, TOS, and dx or DX
DOS - Ans-Date of Service
POS - Ans-Place of service
TOS - Ans-type of service
DX or dx - Ans-diagnosis
HIPAA - Ans-under what rule mays use patients Protected Health Information (PHI) with out specific
authorization for treatment, payment, and operation purposes (TPO).
T in TPO? - Ans-treatment
P in TPO? - Ans-Payment
O in TPO? - Ans-Operations
What does (T)reatment in TPO mean? - Ans-primarily for the purpose of discussion of the patients
case with other providers
What does (P)ayment in TPO mean? - Ans-where providers submit claims on behalf of patients
What does (O)perations in TPO mean? - Ans-for purposes such as staff training and quality
improvement
, Employer Liability - Ans-physicians are legally responsible for their own conduct and any actions of
their employees.
Employee Liability - Ans-"errors and omissions insurance" a protection against a loss of monies
caused by failure through error or unintentional omission on the part of the individual or service
submitting the insurance claim
Let the master answer - Ans-means an employee can be sued and brought to trial
Medical Record - Ans-: documentation on the patients social and medical history, family history,
physical examination findings, progress notes, radiology and lab results, consultation reports and
correspondence to patient
Reason 1 for Documentation of Pt Records - Ans-avoiding denied payments by insurance carriers
investigating the medical necessity of services
Reason 2 for Documentation of Pt Records - Ans-enforcement of record keeping rules by insurance
carriers requiring accurate documentation that supports procedure and diagnostic codes
Reason 2 for Documenting of Pt Records - Ans-Subpoena of medical records by state investigators of
the court review
Reason 4 for Documenting of Pt Records - Ans-Defense of a professional liability claim
Indefinitely - Ans-a M.D. must keep living Pt records for
5 years - Ans-a MD must keep deceased Pt records for
pain - Ans--algia
blood condition - Ans--emia
