EHR Review Chapter 9: Coding and Billing
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Questions and Answers

The following are all examples of classification systems EXCEPT:

  • HCPCS
  • CPT
  • ICD
  • MEDCIN (correct)
  • Which of the following classification systems is used to code outpatient procedures and inpatient and outpatient provider services?

  • SNOMED
  • CPT (correct)
  • HCPCS
  • ICD
  • How does the implementation of electronic health record (EHR) systems affect the process of coding health records?

    It allows for more efficient coding and increases the accuracy of code assignments.

    How does the use of the EHR system benefit the billing processes?

    <p>All of the above.</p> Signup and view all the answers

    What software program reviews bills for possible errors prior to their transmission to the insurance companies?

    <p>Claim Scrubber.</p> Signup and view all the answers

    The term nomenclature refers to a standardized method of assigning codes to diagnoses and procedures.

    <p>False</p> Signup and view all the answers

    Concurrent coding is an easy process to perform with paper records but is made more difficult with the use of an EHR system.

    <p>False</p> Signup and view all the answers

    The insurance plans of insured patients are classified either as managed care plan or indemnity plan.

    <p>True</p> Signup and view all the answers

    The Explanation of Benefits is a report received by a billing supervisor that lists the patient's information and amount paid by Medicare or other payer to the physician practice or healthcare facility.

    <p>False</p> Signup and view all the answers

    The use of standardized classification systems has a direct impact on healthcare.

    <p>True</p> Signup and view all the answers

    Study Notes

    Classification Systems in Healthcare

    • Examples of classification systems include CPT, but MEDCIN is not classified as one.
    • CPT (Current Procedural Terminology) is utilized for coding outpatient procedures and provider services in both inpatient and outpatient settings.

    Benefits of Electronic Health Records (EHR)

    • Implementation of EHR enhances the efficiency of coding health records.
    • EHR increases accuracy in code assignments, which is crucial for proper billing and care coordination.
    • The EHR system also streamlines billing processes by facilitating various administrative tasks.

    Error Review in Billing

    • Claim Scrubber software is essential for pre-transmission billing error review before sending claims to insurance companies.

    Nomenclature and Coding Processes

    • Nomenclature refers to a method of assigning codes; however, it is a broader concept than just standardization.
    • Concurrent coding is simplified with EHR usage, contrary to the belief that it complicates the process.

    Insurance Plan Types

    • Patients' insurance plans generally fall into two categories: managed care plans and indemnity plans.

    Explanation of Benefits (EOB)

    • The EOB is not just a report for billing supervisors; it details the patient's information but does not reflect the total amount billed by the healthcare provider.

    Impact of Standardized Classification

    • Standardized classification systems significantly influence healthcare delivery and coding accuracy, affecting reimbursement processes and overall care quality.

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    Description

    Test your knowledge on coding, billing, and reimbursement in electronic health records with these flashcards. This quiz covers crucial classification systems like CPT and MEDCIN, enhancing your understanding of EHR implementation.

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