HP216B_W5AssignmentResources
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School
Grantham University *
*We aren’t endorsed by this school
Course
HP 114
Subject
Health Science
Date
Dec 6, 2023
Type
docx
Pages
3
Uploaded by KidRainAnteater11
Abbrev.
Name.
Examples and/or Definition
HIPAA
Health Insurance Portability and
Accountability Act
Stolen/lost laptop.
Stolen/lost smart phone.
Stolen/lost USB device
ICD
International Classification of
Diseases
3-7 characters – 3 characters before the decimal
and up to 4 characters after the decimal • 1st
character is alpha (all letters except U are used) •
2nd character is numeric • Characters 3-7 are alpha
or numeric • Alpha characters are not case-sensitive
NOS
Not Otherwise Specified
if it was clear that the person's
symptoms showed they were dealing
with a particular concern
NPI
National Provider Identifier
health care providers with a Type 1
Individual NPI are physicians, dentists,
nurses, chiropractors, pharmacists,
physical therapists BCBA's, and RBT's.
PHI
Protected Health Information
refers to any information that relates to an
individual’s health status, medical history, or
treatment.
POS
Place of Service
A type of plan in which you pay less if you use
doctors, hospitals, and other health care
providers that belong to the plan's network.
POS plans also require you to get a referral from
your primary care doctor in order to see a
specialist.
RVU
Relative Value Units
They are often used to factor compensation.
CMS calculates an individual GPCI for each of
the RVU components, i.e., physician work,
practice expense and malpractice
SOF
Signature
The beneficiary signature is required for Non-
Institutional Providers unless the provider has a
beneficiary signature on file (SOF). You must
indicate “SOF” in the Patient Signature section
of the Claim Form, otherwise the TOP Claim will
be denied.
COB
Coordination of Benefits
allows plans that provide health and/or
prescription coverage for a person with
Medicare to determine their respective payment
responsibilities
DCI
Duplicate Coverage Inquiry
Method used by an insurance
company or group medical plan to
inquire about the existing coverage of
another insurance company or group
medical plan.
Dx
Diagnosis Code
the process of information gathering
and clinical reasoning to determine a
patient's health problem. Accurate
diagnosis requires a medical
professional—whether a nurse
practitioner, physician, dentist, etc.
EFT
Electronic Funds Transfer
the electronic message used by health
plans to order a financial institution to
electronically transfer funds to a
provider's account to pay for health
care services. An EFT includes
information such as: Amount being
paid. Name and identification of the
payer and payee.
EMR
Electronic Medical Records
In contrast to hard copy medical records, an
EMR provides data in a more physician-friendly
manner. For example, data in an EMR is
presented in the form of graphs and pie charts
for different diseases.
MSP
Medicare Secondary Payer
Healthcare Managed Services Program (MSP)
OON
Out-of Network
refers to physicians, hospitals or other
healthcare providers who do not participate in
an insurer's provider network. This means that
the provider has not signed a contract agreeing
to accept the insurer's negotiated prices.
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