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Medical Assisting > WEEK THIRTEEN > Flashcards

WEEK THIRTEEN Flashcards

1
Q

purchase requisitions

A

formal request from staff for supplies/equipement

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2
Q

purchase order

A

form that authorizes a purchase

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3
Q

most common scheduling

A

computerized scheduling

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3
Q

Applying the matrix

A
  • block off times unavailable
  • appointments can be group by provider, appt types, or resources(surgery room/lab)
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4
Q

stream scheduling (time specific scheduling)

A
  • patients scheduled for specific times
  • at regular intervals
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5
Q

wave scheduling

A
  • flexibility for people who are late and/or require more or less time
  • three patients are scheduled at the same time at the top of the hour
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6
Q

Modified Wave Scheduling

A

two patients scheduled at the top of the hour and a 3rd scheduled 30 mins later

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7
Q

Double booking scheduling

A
  • two patients scheduled at the same time
  • work in patients with acute illness
  • creates delays for patients and providers
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8
Q

cluster/categorized scheduling

A
  • grouping patients with similar exam types, conditions, or treatments, within a certain time block during the day (ultrasounds)
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9
Q

established patient

A

person who has received professional services from a physician within a previous 3 years

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10
Q

F/U duration

A
  • follow up appt: 20-30 mins
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10
Q

New patients will be required to fill out

A
  • notice of privacy
  • medical history
  • HIPPA release forms
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11
Q

NP duration

A

new patient: 45- 1hr

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12
Q

S/R duration

A

suture removal: 10 - 20 min

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13
Q

CPE duration

A

Complete physical exam 30-60 mins

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14
Q

CAN

A

cancellation: 0 mins

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15
Q

NS duration

A

No show: 0 mins

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16
Q

P & P

A

Pelvic exam and Pap Smear: 15-30 mins

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17
Q

Superbill or Encounter

A

Created when the medical assistant and physician see the patient in person (billing purposes)

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18
Q

comprehensive appt

A

new or established patient for a specified complaint at highest coding level, multiple complaints, injuries, or worsening chronic conditions

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19
Q

most common size of envelopes

A

no. 10

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20
Q

formal business stationary

A
  • name and address
  • associates
  • phone and fax numbers
  • website info and e-mail
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21
Q

most used outgoing mail

A

first class

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22
Q

most secure outgoing mail

A

registered

23
Q

TDD

A

Telecommunication device for the deaf

24
Q

5 C’s of effective communication

A
  • completeness
  • consideration
  • conciseness
  • concreteness
  • clarity
25
Q

Five basic steps for filing

A
  • conditioning
  • releasing
  • indexing & coding
  • sorting
  • filing
26
Q

electronic medical record

A

digital charts to be used within a facility

27
Q

electronic health record

A

includes EMR and other info used between facilities

28
Q

Personal health record

A
  • access controlled solely by patient
29
Q

release of information form

A
  • also known as HIPAA form
  • allows practice to share patient info
30
Q

consent to treat form

A
  • gives the physician permission to treat a child
31
Q

meaningful use

A

guidelines imposed by the Health Information Technology for Economic and Clinical Health (HITECH) ACT in 2009
- improves quality, safety, efficiency, and reduce health disparities

32
Q

deductible

A

patient must pay out of pocket before insurance begins paying

33
Q

coinsurance

A

insurance company share the cost of service

34
Q

copayment

A

amount paid at the time of service

35
Q

assignments of benefits

A

form signed by the patient to allow the provider to be paid directly by the insurance company

36
Q

participating provider

A

providers that agree to write off the difference between that amount charged and the allowed amount by the insurance company

37
Q

allowed amount

A

the maximum amount the insurance company will pay for a service for product

38
Q

advanced beneficiary notice

A

patient being responsible for payment because Medicare will not cover the service

39
Q

explanation of benefit

A

statement from insurance company to patient outlining amounts billed

40
Q

preauthorization

A

contacting the insurance plan to see if a procedure is a covered

41
Q

medicare

A

cover patient 65 and older

42
Q

medicare part A

A

hospitalization

43
Q

medicare part B

A

routine medical office visits and outpatient services

44
Q

medicare part C

A

optional additional coverage offered by private companies approved by Medicare

45
Q

medicare part D

A

medications

46
Q

medicaid

A

covers low income and mentally indigent

47
Q

tricare

A

covers military personnel and dependants

48
Q

CHAMPVA

A

covers spouse and dependent children of veterans who passed away

49
Q

Workers Compensation

A

covers workers against lost wages due to accidents on the job

49
Q

Children’s Health Insurance Program (CHIP)

A

provides low-cost health coverage to children who’s in a household that earn too much money

50
Q

managed care health plans

A

plans that provide healthcare for payments

51
Q

HMO

A
  • contracts with providers and hospitals to provide preventative and acute care
  • requires referrals, PCP, preauthorization
52
Q

PPO

A
  • no referrals needed
53
Q

fee- for-service

A

amount charged for services is controlled by the insurance carrier

54
Q

pay-for-performance

A

compensates providers only if certain measures are met for quality and efficiency

55
Q

capitation

A
  • patients are assigned a per month payment based on age, race, sex, lifestyle, medical history
56
Q

coordination of benefits

A
  • prevents duplication of payment
  • primary insurance plan pays first
  • secondary plan pays the deductible and copayment after the processed their claim

Medical Assisting (10 decks)

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