TP- Module 11

Patient Appointments #1-

What does CMS stand for?

• Clinical Medical Section

• Centers for Medicare & Medicaid Services

• Centers for Medical Services

• Certified Medical Sections

Patient Appointments #2-

What is PMS?

• practice management system

• paper medical records, current records are stored on site, and archived records would be stored at a convenient offsite location to allow for retrieval as necessary.

• The time required for medical record retention varies by state.

• Software used to electronically manage administrative functions, such as scheduling appointments, integrating patient documentation from electronic health records, coding, billing, and revenue cycle tasks such as running aging reports and managing the accounts receivable.

Patient Appointments #3-

What is RTA?

• real-time adjudication

• Software used to electronically manage administrative functions, such as scheduling appointments, integrating patient documentation from electronic health records, coding, billing, and revenue cycle tasks such as running aging reports and managing the accounts receivable.

• A tool that allows for a submission of the coded visit to the insurance company by participating providers for reimbursement decisions by third-party payers while the patient is present.

• A federal agency that oversees the Medicare program and assists states with Medicaid programs.

Patient Appointments #4-

Comprehensive

• Thorough review of body systems including preventive care and screenings

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

• Non-patient related (depositions, sales, representatives, staff meetings, training)

• Medically necessary within 24 hr

Patient Appointment #5-

How long should a new patient telehealth be?

• 15 min

• 30 min

• 20 min

• 60 min

Identify and Check Patients In and Out #1-

Define AVS.

• Document that identifies how the provider will distribute and disclose a patient’s protected health information.

• The amount that must be paid before benefits are paid by the insurance company.

• Information that includes follow-up appointments, provider orders, instructions, educational resources, and financial account information.

• The percentage of the allowed amount the patient will pay once the deductible is met.

Identify and Check Patients In and Out #2-

What is coinsurance?

• Document that identifies how the provider will distribute and disclose a patient’s protected health information.

• The percentage of the allowed amount the patient will pay once the deductible is met.

• Information that includes follow-up appointments, provider orders, instructions, educational resources, and financial account information.

• The amount that must be paid before benefits are paid by the insurance company.

Identify and Check Patients In and Out #3-

What is a deductible?

• Information that includes follow-up appointments, provider orders, instructions, educational resources, and financial account information.

• The percentage of the allowed amount the patient will pay once the deductible is met.

• Document that identifies how the provider will distribute and disclose a patient’s protected health information.

• The amount that must be paid before benefits are paid by the insurance company.

Identify and Check Patients In and Out #4-

What is NPP?

• The percentage of the allowed amount the patient will pay once the deductible is met.

• Document that identifies how the provider will distribute and disclose a patient’s protected health information.

• The amount that must be paid before benefits are paid by the insurance company.

• Information that includes follow-up appointments, provider orders, instructions, educational resources, and financial account information.

Identify and Check Patients In and Out #5-

The MA will verify the patient’s identity, ______, and insurance information.

• eligibility

• DOB

• SSN

• Ethnicity