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Billing Chapter 1 and 5

Horizontales
Common Law
special contract clause stipulating additional coverage
_______ care; organized to manage health care costs, utilization, and quality.
expands the definition of medical care to include preventive services.
referring patients to specialists.
electronic format supported for health care claim transactions.
actions inconsistent with accepted, sound medical, business, or fiscal practices.
Services designed to help patients avoid problems with health and injuries.
process of reporting diagnoses, procedures, services, and supplies
Patient Protection and Affordable Care Act (PPACA)
Primary Care Provider
Verticales
Party Payer; BlueCross BlueShield
requirements established by accreditation organizations.
conduct or qualities that characterize a professional person.
federal, state, county and municipal laws
Triple option plan
Patient ______; documents health care services provided to a patient.
To decode an encoded computer file so that it can be viewed;
to convert information to a secure language format for transmission.
electronic Clinical Quality Measure