Bundle: Understanding Health Insurance: A Guide To Billing And Reimbursement, 14th + Law, Liability, And Ethics For Medical Office Professionals, 6th ... For Green's Understanding Health Insu
14th Edition
ISBN: 9780357014738
Author: Michelle Green
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…
When a patient is being admitted from home,
the social worker should arrange for the medical records on the patient's last
hospitalization.
the facility should begin recording the patient's past history and background.
prior medical records are generally not available.
the social worker should obtain medical records from the admitting physician's
office.
A PATIENT’S RECORD UNDERWENT REVIEW BECAUSE THE OUTPATIENT DIAGNOSIS ABOUT MULTIPLE INJURIES WAS UNCLEAR. WHO IS AUTHORIZED TO CLARIFY THE DIAGNOSIS?
HEALTH CARE PROVIDER
HIM SUPERVISOR
INSURANCE COMPANY
OUTPATIENT CODER
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- When 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_forwardWhat part of the nursing care plan is the patient's complaint? Don't plagiarism.arrow_forwardThe nurse enters a clients room room and notes that the client's lawyer is present and the client is preparing a living will The living will require s that the client's signature be witnessed, and the client's asks the nurse to witness the signature. which is the appropriate nursing action.arrow_forward
- You are an administrator in the Intensive Care Unit (ICU). The Physician approaches you for assistance with her patient Mr. Jones and Mr. Jones’ family. The Physician explains that Mr. Jones no longer requires the level of care that is provided in the ICU and wants to transfer Mr. Jones to an acute medical unit. Jones is ‘incapable’ so his daughter is making treatment decisions on his behalf. Jones’ does not have a Power of Attorney for Personal Care, his spouse passed away many years ago, and is daughter ranks next on the substitute decision-maker hierarchy. The issue that the Physician is facing is that Mr. Jones’ daughter does not want her father transferred out of the ICU and is telling the Physician and the staff that she does not give her consent for him to be transferred. Question: Using your critical thinking skills and what you’ve learned about the Health Care Consent Act, what advice do you give the Physician in this case? Explain your…arrow_forwardPhysical locations where health care is provided to patiemts (eg office or other outpatiets settings, hospitals, nursing facilities, home health care or emergency departments the two digit location code is required by medicarearrow_forwardYou are the MOA in a busy family practice. The following calls come in to your office. For each situation, respond in the most appropriate manner. How would you handle each call? If it is for your physician, do you put the call through? Do you take a message? Can you handle the call yourself? Provide a brief explanation for each example. “Hi, my mother was in to see the doctor yesterday. Ever since then she has been quite upset. She won’t talk to me about it. I want to know what is going on.”arrow_forward
- A nurse receives a new order from the healthcare provider to keep the client nothing by mouth (NPO). which member(s) of the healthcare team need to be alerted to the new NPO order? Select all that apply. case manager respiratory therapist dietary personnel wound care nurse unlicensed assistive personnelarrow_forwardEllen Armstrong, cmas (amt), is responsible for all patient insurance billing procedures, Ellen has the following information: Total charges Allowed charges Office visit $150.00 $100.00 Return visit $80.00 $75.00 Deductible has not bee satisfied. Calculate the patient's correct billing if the provider accepts assignment. Calculate the patient's correct billing if the provider does not accept assignment.arrow_forwardScenario: You are the MOA in a busy family practice. The following calls come in to your office. For each situation, respond in the most appropriate manner. How would you handle each call? If it is for your physician, do you put the call through? Do you take a message? Can you handle the call yourself? Provide a brief explanation for each example. “Hi, I would like to make an appointment to see the doctor. I had my X-ray done yesterday, and let me tell you, it was quite an ordeal. First, I had a hard time getting down to the hospital. Then, I got lost… I’m not sure how that can even happen, but then this really nice lady offered…”arrow_forward
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