Shared Flashcard Set

Details

MAB 120
Questions
35
Medical
Undergraduate 1
12/06/2010

Additional Medical Flashcards

 


 

Cards

Term

What is the job of the receptionist every morning?

 

Definition

Arrive at least 30 minutes prior to the first appointment, retrieve the messages and prepare the charges and office

Unlock appropriate doors, disengage alarm system, turn on appropriate lights, turn on computers, printers, copiers, and other electronic devices and check for specimens that may have been forgotten

Term

Where should the receptionist check for messages at the begining of each day?

 

Definition
Answering service, voicemail systems, electronic mail, facsimile machines
Term
How should patents be greeted by the receptionist?
Definition
Make every attempt to greet patients personally, register and orient patients, make sure new patients complete a registration form called a patient information sheet, then orient the patient to the offive and manage the wait time by notifiying the patient when they'll be seen
Term

Who can you demonstrate the professional image to a patient?

 

Definition

Professional image consist of good attitude, being a good role model, and using courtesy and diplomacy in the office

Attitude- is a state of mind of feeling regarding some matter

Role Model- includes good health, good grooming, positive image and follow the dress code

Diplomacy- is the art of handling people with tact and genuine concern

Term
What are the 5 basic guidelines for telephone use?
Definition

1. Dictation- refers to how words are spoken and enunciated

2. Pronunciation

3. Expression

4. Listening

5. Coutesy

Term
What do you write in the appointment book?
Definition
Patient information such as name, telephone number and reason for visit, make sure there is matrix for each doctor and block out time that is not avalible and if manual makeu sure there is enough space for information in appointment book
Term

What do you do when you schedule a new patient?

 

Definition

1. Allow an adequate amount of time for the appointment

2. Explain the office's payment policy

3. Be sure the patient knows where the office location is and give direction if needed

4. Some patients are sensitive about messages get safe place to call and leave messages

5. Before ending the call confirm the time and date of appointment

6. Always check the appointment book to make sure information is correct

7. If the patient is referred by another physican may need to call referred office ahead a time to get lab work

 

Term

Why would you prefer to enter claims electronically?

 

Definition
Claims can be filed immediately reducing the time for the reimbursement cycle; several regional and national clearninghouses recieve health benefits claims end electronically directi them to the appopriate claims adminstrator which alls you to gile claims through one clearinghouse rather than filing sepratly though each claims adminstrator allows for less errors and faster reimbursement times
Term

What are the different types of reminder systems?

 

Definition

Appointment cards

telephone reminders

Mailed cards

Term
When answering the phone what is your first responsiblity when handling an office emergency?
Definition

The first responsibilty is to determine whether the problem can be treated in the office reter to STAT ask specific questions to determine if they need to be seen immediately or go to the emergancy room

STAT-Immediately

Term
What can happen if you write an inaccurate business letter?
Definition
Inaccurate information in some letters can lead to injury of the patient and lawsuites and can harm the physicians practice
Term
What are the 3 letter formats?
Definition

1. Full Block- each line is flush left; is the most formal and is most commonly used for professional letters

2. Block- the date, subject line, closing, and signatures are flush right and all other lines are flush left

3. Semiblock- the first sentence of each paragraph is indented 5 spaces; also referred to as modified block

 

Term

Who does Medicare cover and how are they enrolled?

 

Definition
Medicare provides coverage to the elderly defined as a person age 65 or older and persons who have been recieving social security benefits for 24 months and person suffering from end-stage-renal diseasel people recieving social security benefits are automatically enrolled in medicare part A and part B the can opt-out for part B
Term
What is the difference between part A and part B?
Definition

Part A- covers hospital expenses and is provided at no additional charge to persons eligible for social security benefits

Part B- pays for phyician fees, both inpatient and out patient, diagnosic testing, certain immunizations, and specific screening test and is optional there is a fee which is deducted from the monthly social security payment

Term
What form do you use to submit a insurance claim?
Definition
Health Insurance Claim Form
Term
What is listed in Box 1 of the health insurance claim form?
Definition

Box 1 is where the vlaim is being submitted; confirm the patient's coverage and accuracy of your file information a change in the paitents coverage will change hou the claim is filed

 

Term

Why would you audit a chart?

 

Definition
Helps improve the quality of care, accurate billing, detecting fraud, and allows errors to be found before and actual chart audit and accurate care
Term
What is TRICARE and who does it cover?
Definition
New name is CHAMPUS is admistered by the US Dept of Defense and provides medical coverage to dependants of active service, dependants of service personnel who have died during active service and retired service personnel
Term
What are DRG's and what are they used for?
Definition

DRG- Diagnostic Related Group are categories into which inpatients are placed according to the similarity of their diagnoses, treatment and lengh of hospital stay used primarly for reimbursement for Medicare patients

 

Term
What are the 4 key elements of a managed care program?
Definition

1. Precertification of hospital admissions

2. Approved referrals

3. Network

4. Assignment of benefits

 

Term
What are the 3 volumes of the ICD-9 book?
Definition

Volume 1- contains the classification of diseases (conditions) and injuries by code numbers, grouping of disease and injuries by etiology or cause and anatomic system each chapter had heading or title and follow the 3 diget categories

Volume 2- Alphabetic Index to disease contain diagnostic terms that do not appear in volume 1 and is divided into 3 sections

-Section 1 Alphabetic index to disease and injuries is organized by main terms printed in bold face type and used for reporting the reason for the patient encounters for most insurances

-Section 2 Table of Drugs and Chemicals

-Section 3 Alphabetic Index to external causes

Volume 3- Tabular List and Alphabetic Index of Procedures is used for inpatient facilities and is based on anatomy not surgical specialty

Term
Who has to approve the changes to the ICD-9 codes?
Definition
WHO
Term
What is the HIPPA security rule intended to prevent?
Definition
Breach in confidentality
Term
How does a debit adjustment affect a patients account?
Definition
A debit adjustment adds to the patients account balance which affects the balance on the account
Term

What is the most common bookkeeping system?

Definition

Most medical pratices use the single-entry bookeeping system

Term

How does insurance capitation work?

 

Definition

Capitation- managed care plan that pays a certain amount to a provider over a specific time for caring for the patients in the plan regardless of who or how many services are preformed

 

Term
What is professional courtesy?
Definition
Are an adjustment in which other health care professionals are charged a reduced rate and a physician may choose not to charge a fee at all
Term
Refund
Definition
Term
Credit Balance
Definition
Term
What do brackets mean?
Definition
Term
What are the things you should not do when answering the phone?
Definition
Term
What are the 3 mechanics of a letter?
Definition
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