Case Studies in Health Information Management
3rd Edition
ISBN: 9781305955332
Author: Patricia Schnering, Nanette B. Sayles, Charlotte McCuen
Publisher: Cengage Learning
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Drag the missing term into each sentence/paragraph text related to completion of the 837 P claim.
The HIPAA 837P uses the term
for the insurance
diagnosis
account
or guarantor, meaning the same as
on the
CMS-1500 clalm.
The name and address of any
than the subscriber or patient who has
is reported if applicable.
party, the entity or person other
responsibility for the bill,
submission
line
filing indicator code is an administrative code used to identify
data
health
the type of
plan, such as a PPO.
and the subscriber are not the same person, an
code is required to specify the patient's relationship
When the
claim
attachment
individual
to the subscriber.
Although sometimes called the patient
number, the claim
number should not be the same as the practice's account
insured
electronic
number for the patient.
The claim
code, also called the claim
financial
policyholder
code, for physician practice claims indicates whether this claim is an original, a
or needs to be voided.
A total of four…
A request for a patient’s medical record is sent by fax to your office. The fax cover sheet contains the letterhead of a nearby medical facility. You do not recognize the name of the physician, fax number, or telephone number stated for the physician’s office. How do you respond to the request?
Prescriptions, biennial inventories, invoices, and Forms 222 and 41 must be readilyretrievable (able to be produced within ____________________. hours of the request).
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- ello, Can you please help me with the next case? You are the nurse manager of a 15-bed step-down unit in a metro-area hospital. You employee RNs, UAPs, and unit secretaries to staff the unit. You are not responsible for staffing or the budget related to other ancillary hospital staff. These are your staffing ratios for 12-hour shifts. Staffing on day shift and night shift are the same. RNs: 3:1 ratio UAPs: 6:1 ratio Secretary – one per shift Your 15-bed unit had 372 patient days in July. Calculate the average daily census (ADC). Discuss the daily staffing patterns for the unit based on the ADC. How many staff from each discipline do you schedule each day? What are the downfalls of the nurse-patient ratio staffing model? Discuss an alternative staffing model. Thank you in advance!arrow_forwardA physician requests that you change the “date of dictation” on a medical report to 3 days before the actual date of dictation so that the report will appear to have been dictated in a timely fashion. He explains that he was called out of town for a family emergency and fell behind in his dictation, and that he appreciates your cooperative and helpful attitude with small requests such as this. What do you do?arrow_forwardThe physician has a written order in the patient's chart. "Give 60 mg of Amoxicillin." The medication is available as argral suspension that contains 125 mg/5 mL. How many milliliters should the nurse administer? Record your answer using one decimal place.arrow_forward
- I need the answer as soon as possiblearrow_forwardRead the writing and write two paragraphs of 5 sentences providing information that is not in the writing . Put referencesarrow_forwardEmma Mastrangelo had a CT scan of the brain today because of recurrent migraines. Total charges are $720.50. Her benefits pay 90 percent of this procedure. The allowed amount is $462.60. What is the patient responsibility, discount amount, and the amount the carrier pays provider?arrow_forward
- Emma Mastrangelo had a CT scan of the brain today because of recurrent migraines. Total charges are $720.50. Her benefits pay 90 percent of this procedure. The allowed amount is $462.60. What are the patient's responsibility, discount amount, and the amount the carrier pays the provider?arrow_forwardWhen the patient presents with a non life threatening issue, the provider is most likely to access the full electronic health record (EHR) to assess for A Patient history and allergies B Self pay status C Social Security number D Marital statusarrow_forwardhttps://mylearning.suny.edu/d21/le/content/1496105/viewConten Ch 9 Medical Record Activity Page 1: What is Cindy's chief complaint or reason for visit? 1 Page 2: 21 Page 3: 3> Page 4: 41 Page 5: 5 Page 6: Cindy is a 17-year-old high school student. She leads an active social life, gets good grades, and is a member of the track team. About two weeks ago she became ill with what she thought was the flu. Her signs and symptoms included sore throat, enlarged and tender lymph nodes in her neck, inflamed tonsils, headache, fever, muscle aches and fatigue and loss of appetite. She expected to feel better by now, but she still has many of the symptoms. Her mother took Cindy to their family physician for evaluation. Upon examination the physician notes that Cindy has swollen lymph nodes in her neck and armpits, her spleen is enlarged. Based on her symptoms and examination the physician diagnosed Cindy with the Epstein-Barr virus. He explained that there is no specific cure, but that treatment…arrow_forward
- Read the writing and write two paragraphs of 5 sentences providing information that is not in the writing .arrow_forwardA patient received $800 medical procedure . The patient has an insurance plan with a 70/30 coinsurance agreement and a $200 deductible which they have not met . The insurance allows $550 on the procedure and the provider will write off the difference in cost . How much will the insurance be responsible for? How much will the patient be responsible for?arrow_forwardMethod of assignment You are assigned as student head nurse to general surgical unit , in X hospital, the unit design is H shape ,the unit capacity is 28 beds, distributed on fourteen rooms each room has two beds. Your clinical instructor asking you to develop an assignment sheet for nursing staff who are working in this unit; you have twenty patients, Four of them are immediate post operative, are housing in Rooms number 4, 7. Twelve patients are Intermediate care (require above average amount of nursing care) distributed on the following Rooms numbers; 1,2,3,5, 6,8 and four patients are Partial care (require an average amount of nursing care) allocating in room 9,11. You have two professional nurses, and two technical nurses their years of experiences are; 5,4,3,2 consecutively. In light of this information, fill an assignment sheet pointing out method of assignment you are going to use, state your justification, principles of assignment that you must put in consideration in…arrow_forward
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