Term 1 of 243
Key performance indicators (KPIs) for effective claims managment
PALMER
DENR
COPE
DAR
Term 2 of 243
Presents vendors with data about the medical group's operations, plus specific data about the
operations being considered for a computer acquisition or enhancement.
SOW
RFP
RFQ
RFI
Term 3 of 243
The total fixed cost divided by the contribution margin per uit equals:
point of service collections
the break-even point in sales volume
ensuring successful completion of the contract
average days of revenue in receivables
,Definition 4 of 243
represents the excess cost required to acquire a business over and above what would be
considered the sum of the fair market value of its assets less its liabilities.
Public Relations
Goodwill
Inventory
Define Coaching
Term 5 of 243
A 403(b) plan
Geographic adjustments
is available only to family farmers.
also known as a tax-sheltered annuity plan, is a retirement plan for certain employees of
public schools, employees of certain Code Section 501(c)(3) tax-exempt organizations and
certain ministers.
production formulas designed to reward physicians in direct relationship to the revenue
they produce.
Term 6 of 243
Revenue budget
is the calculation of employee salaries
is the process of reducing costs
is a projection of income from all sources
is the estimation of total company expenses
,Definition 7 of 243
results when a patient who has been determined to have the financial capacity to pay for
healthcare services is unwilling to settle the claim (for example, a patient who has a bank account
or other assets but chooses not to pay a legitimate bill).
Uncollectable Account
Bad Debts
Investment In Health Education
Contracts
Definition 8 of 243
Collection of funds. It should occur as rapidly as possible, normally within 24 hours of service.
Charity accounts
Charge posting
Differential costing
Contracts
, Definition 9 of 243
*A vendor may have access to staffing and/or computer systems not available to the medical
group.
*The vendor assumes responsibility for hiring, training, and supervision of staff.
*The vendor may accept a contract that includes some financial risk if the cost of handling A/R
increases or that includes an "efficiency" factor.
*A vendor may receive economies of scale, not available to smaller medical groups, by handling
A/R in a central location for a variety of groups
*If A/R billing and collections are outsourced, it is critical to manage the vendor closely and hold
them accountable for pre-determined and agreed-to deliverables.
D&O insurance:
Steps in the Credentialing Process:
Stop-loss insurance coverage
Outsourcing Advantages
Definition 10 of 243
To provide info to the insurance plan about the treatment the patient received.
Differential Costing
System Analysis
Purpose of Encounter
Capitation Formulas
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