Definition of Terms Essay

AMR- Ambulatory Medical Record- An ambulatory aesculapian record (AMR) is an electronically stored file of a patients outpatient medical exam records, which includes all surgeries and business concern that do non involve being admitted to a hospital.The importance of AMRs is that they only apply to outpatient medical records. Outpatients procedures or serve are performed so frequently that at times it can be tedious to keep track of them. These records allow a physician to revaluation a patients COMPLETE medical history. CMR- Computerized Medical Record- Computerized medical records are the digital counterparts to patient medical records kept in opus files and folders in wellness care offices.The importance of CMRs is they allow for slight paper storage or use. A patients medical records can be an extensive file. The longer the file gets the harder it is to keep up with it. Keeping a computerized copy of what is on paper in a patients medical record is more(prenominal) tha n convenient, it is a more efficient mode of documentation. CMS Centers for Medicare and Medicaid- The Centers for Medicare & Medicaid Services (CMS), previously known as the wellness Care Financing Administration (HCFA), is a federal agency within the United States Department of wellness and Human Services (DHHS) that administers the Medicare program and working in partnership with state governments to administer Medicaid, the State Childrens Health Insurance Program (SCHIP), and wellness insurance portability standards.CMS is an important entity to US healthcare, without it, the medical reportage forchildren whose parents do not have the luxury of commercial coverage and the elderly who have reached the age of retirement would not have health benefits. Medicare and Medicaid do not only supply benefits to children and the elderly but thither are those citizens who are considered disable in some way, shape, fashion or form. CMS-1500 A widely distributed claims charge form u se by physicians and opposite healthcare practitioners to bill payers for professional go.The CMS 1500 form assists physicians especially in receiving reimbursement for the run provided. The development of a form for physicians eliminates confusion for insurance companies when processing claims. The companies film not worry about whether the charges were submitted by a physician or adroitness, which makes for easier and more efficient processing. CPT Current Procedural Terminology (CPT) is a ordinance set that is used to report medical procedures and services to entities such as physicians, health insurance companies and accreditation organizations. CPT is used in conjunction with ICD-8-CM or ICD-10-CM mathematical diagnostic coding during the electronic medical billing process.From a billing standpoint, a world without CPT codes is almost like a world without people. The panache idea to use a universal language of numbers to delineate services an separate had performed a lleviates chaos. CPT codes also give a shorter definition of the services rendered. Some procedures are so extensive, all the learning appearing on a claims form can cause confusion. By giving these procedures a 5 digit number which can be researched for a description creates efficiency. DRG Diagnosis Related Group any of the payment categories that are used to classify patients, especially Medicare patients, for the purpose of reimbursing hospitals for each facial expression in a given category with a fixed fee regardless of the veridical costs incurred DRGs prohibit a facility from receiving an outrageous reimbursement for ad hoc provided services.The categorization of patient cases into particularized groups which allows for a set cost or billed amount places a cap on reimbursement to that facility for that case/patient. EPR Electronic Patient (Health) Record (EHR) -an evolving concept defined as a systematic collection of electronic health information about individualpa tients or populations. Monitoring a patients health information in an electronic manner is a win/win for all involved. It allows the patient double-quick access to their records and the physician or hospital a faster system for reviewing or receiving those same records. The EPR has evolved into the EHR. The development of tracking patient health information in an electronic monitor has produced a more effective, accurate method for organizing something as lengthy as a persons health history.HL7 Health Level Seven (HL7) a non-profit organization involved in the development of international healthcare informatics interoperability standards. HL7 and its members provide a theoretical account (and related standards) for the exchange, integration, sharing, and retrieval of electronic health information. The 2.x versions of the standards, which support clinical execute and the management, delivery, and evaluation of health services, are the most commonly used in the world.The develop ment of this organization is the foundation for the ability to transfer and track health information safely and without violation of a persons individual(prenominal) information. Without HL7, the above mentioned term (EPR) would not exist. This organizations importance is beyond measure in terms of convenience involved in the healthcare field. The standards set forth are a necessity in edict for health information to be exchanged or shared, they provide mollification of mind to the patients and physicians. ICD-9 world(prenominal) Classification of Disease, 9th edition A standardized compartmentalization of disease, injuries, and causes of death, by etiology and anatomic localization and codified into a 5-digit number, which allows clinicians, statisticians, politicians, health planners and others to speak a common language, both US and internationally. A 3 to 5-digit number code describing a diagnosis or medical procedure.The International Classification of Disease 9th editio n is as important to billing as CPT codes. The universal language for identifying a patients diagnosis assists not only for purposes in billing but for physician and hospital communication with insurance companies. Physicians cite school to learn and become familiar with the white-tie name for specific diseases, injuries and other medical conditions. On the other hand, insurance companies may not be as familiar or educated as tothe formal names for these medical conditions, which is where ICD-9s come into play. They allow for easier and more correspondence within the communication aspect of physician to insurance or facility to insurance company.UB-92 Uniform/Universal Billing form 92 Managed care The official HCFA/CMS form used by hospitals and health care centers when submitting bills to Medicare and 3rd-party payors for reimbursement for health services provided to Pts covered. UB-92 billing forms have since been replaced with UB-04 billing forms. Needless to say, a universal billing form creates an efficient, more precise method of billing for hospitals. erstwhile again it eliminates the time that would be consumed by insurance companies attempting to determine if a claim is for a facility or physician. Eliminating this step assists in pass through starting the processing of reimbursement to a facility for rendered services.