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    What are six items needed to complete the CMS 1500?Which of the following steps to medical billing should be performed prior to rendering medical services group of answer choices?What type of information is collected from the patient during scheduling quizlet?What the process by which an insurance carrier allows a provider to submit insurance claims directly to the carrier electronically?
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i. Comfort: furniture should be aesthetically pleasing, comfortable, and durable, chairs maintain a degree of privacy, a mixture of soft/hard chairs, small chairs are comfortable for children, low-key color scheme/muted pastels are preferable to bright colors, comfortable temperature.
ii. Safety: clean and uncluttered, arranged for walking
iii. Sanitation: check several times a day to make sure waiting room is clean/tidy, liability is a concern if patients slip or fall, clean children toys, easy to clean toys, sick and well-child visits

i. Letters: a letter head (name of practice/physician, address, phone number, fax number, email, website, company logo), date (month, day, and year), inside address (name and address of the person wo whom the letter is being sent), subject line (optional, used to state the intent of the letter or regarding), salutation (greeting), body toàn thân of letter (contains message), closing (concludes the letter), signature and types name, identification line (optional, who wrote the letter), enclosure (something that is included with the letter, and copy (c used to indicate that a duplicate letter has been sent).
ii. Memos/Interoffice Communications: heading (memo), date, to (list of names of all recipients), from (list the name and title of the person), subject (insert a brief phrase describing purpose), body toàn thân (write the message of memo), copy (c, same as letter).

i. Routine Maintenance: office managers key responsibilities, to keep the office neat, clean, safe, efficient, and well organized, OSHA requires you to use a licensed vender for biohazardous waste, a well-lit attractive entrance and waiting area, check lobby periodically for neatness.
ii. Safety Precautions: OSHA requires PPE, TB prevention, management of biohazardous waste, ergonomics, and laser protection, OSHA requires the QI programs be in place to protect the health and welfare of patients and employees.

1. Identify Required Information: allow an adequate amount of time for appointment/attain as much information as possible (full name, mailing address, day and evening phone numbers, reason for visit, name of referring physician, responsible party/insurance), explain offices financial policy (payment time of visit), be sure patients known office location, ask patient if it is okay to call home or work, before ending calls confirm date and time of appointment, check appointment book to make sure you scheduled an appointment, you may need to call referring physician in advances for lab work/reports.

patients might feel uncertainty, embarrassment, shyness, or fear, with a patient in an emotionally state miscommunication can lead to a negative response from the patient, check why patient wants to see physician, how long the patient has had symptoms, whether the problem is acute/chronic, most convenient time for the patient to come (early mornings), any special transportation services, whether the patient need to see other office staff, third party payers, receipt of necessary documentation, DO NOT OVERLOAD THE SCHEDULE.

i. appointments made while patient is still on office, determine exact tests the physician requires and how soon the results are needed, check with patient about time restrictions, give patient name, address, telephone number, the exact test or tests required, some require advanced preparation by patient you should give patient a written and verbal explanation of requirements and make sure they understand the importance, not outside facility in patients chart. For surgery determine patients need for precertification with insurance, you may have to call the number on the back of the insurance card, operating facility will need to know the exact procedure, amount of time needed, type of anesthesia requires, and any special instructions (also patients name, age, address, phone number, insurance information, recertification number), note in patients record the name of operating facility, date and time of surgery.

ALL PATIENTS (NEW PATIENTS TOO) WITH APPOINTMENT SCHEDULED IN ADVACNE SHOULD RECEIVE A PHONE CALL REMINDER THE DAY BEFORE THE APPOINTMENT, computers systems can place the call to the programmed number and remind the patient of the appointment with a prerecorded message, do not call work to leave a message if you do not have the permission to do so, reminder should be simple = identify office, yourself, name, and time of appointment, should help jog thành viên of patient, keep a list of patients and phone numbers of patients who have asked to be called sooner (cancelation list), make a notation on appointment schedule (confirmed, left message).

managed care companies usually require that the patient pay a certain share of the bill, provide an office brochure that lists office address, phone number, hour, practice's financial policies (when payments are due, third party payments, how they are handled, when accounts are delinquent, and collection process, patients should understand co=pays are due the time of service, IDEALLY YOU SHOULD COLLECT THE ENTIRE AMOUNT DUE FROM A PATIENT ON THE FIRST VISIT.

i. Level 1: CPT-4, a five-digit numeric coding system maintained by American Medical Association, comprehensive list os medical terms and codes for uniform coding of procedures and service provided my physicians, new codes required on January 1st, provider must buy new addition each year, available in books or software. 6 major sections: Evaluation and Management, Anesthesia, Surgery, Radiology, Pathology, and Laboratory, and Medicine. Appendices widely used in the outpatient arena A-C. Appendix A is a listing of the modifiers available to help further explain a code. Appendix B is a summary of the additions, deletions, and revisions made since the last edition of CPT-4. Appendix C includes clinical examples designed to asset providers in the selection of Evaluation and Management. Level 2: standardized coding system developed primarily for Medicare but used by other carriers to identify products, supplies, and certain services not include in CPT-4 codes. Level 3: referred to as local coded, established when an insurer preferred that supplied use local code to identify a service, which there is no Level 1 or level 2 codes.

to provide health insurance for elderly social security recipients age 65+, disabled persons who have been receiving social security for 24 months, and person suffering from end stage renal disease. PART A = hospital expenses, no additional cost to person eligible, PART B = pays for physician fee, both inpatient/outpatient, diagnostics testing, certain immunization, screening, OPTIONAL, charged a PREMIUM. MUST DECLINE PART B, after ductile has been meet it has a 80/20 split

Advance Beneficiary Notice (ABN): wavier of liability, a notice a provider should given before you receive a service, based on Medicare cover rules, your provider has reason to believe Medicare will not pay for service.

Sets with similar terms

What are six items needed to complete the CMS 1500?

After the procedure was completed, what are six items needed to reference when completing the CMS-1500 Health Insurance Claim Form?. Patient health record.. patient insurance card information.. encounter form.. insurance claim processing guidelines.. patient registration form.. precertification information..

Which of the following steps to medical billing should be performed prior to rendering medical services group of answer choices?

Which of the following steps to medical billing should be performed prior to rendering medical services? Preauthorization specifically determines the dollar amount approved for the medical procedure, while precertification gives the provider approval to render the medical service.

What type of information is collected from the patient during scheduling quizlet?

The patient's name, address, phone number, date of birth, insurance information, and the employer's name and phone number. why is it important to ask the reason for the patient's visit? It allows the assistant to correctly schedule the appointment.

What the process by which an insurance carrier allows a provider to submit insurance claims directly to the carrier electronically?

Clearinghouses are essentially electronic stations or hubs that allow healthcare practices to transmit electronic claims to insurance carriers in a secure way that protects patient health information, or protected health information. Tải thêm tài liệu liên quan đến nội dung bài viết What items should the medical assistant gather when using the paper method to obtain a precertification for a service or procedure quizlet?

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