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Translate Case

Essay by   •  March 25, 2013  •  Case Study  •  1,311 Words (6 Pages)  •  1,231 Views

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Translate and define the following abbreviations. In a short paragraph, share what you would consider the most important aspect of each.

AMR - Ambulatory medical record. This is an electronically stored record of outpatient medical records specific to each patient. This includes all surgeries the patient has had along with care that was received that did not require admission into the hospital. These records are stored in ambulatory medical record systems (AMRS) that can be accessed by physicians and other medical professionals. These records aid in the ability of physicians to view accurate and complete medical histories.

I feel the most important aspect of an AMR is that it documents procedures that were performed outside of the facility that did not require hospital stays. When I had my tonsils out, it was outpatient surgery, however, I feel as if this was a pretty significant approach to my health. It was not done by my family doctor, though it was suggested by him. I had a few problems afterwards that would be found in this record. This information could be extremely important in the event that I was unsure of what was happening. Also, if I moved, I would not have to worry about carting all that information around with me.

CMR- Computerized Medical record. This is a form of an electronic medical record that makes documents of level one electronically available. They are the digital versions of medical records concerning patients. Instead of documenting patient records by hand, the information is instead entered into the computer, making the information available instantaneously.

I think the most important aspect of a CMR is that they help to eliminate errors and save patients time during visits. They do not have to wait for employees to find information in their records. Searching and recovering medical records can be time consuming, versus clicking a button and they are pulled up on the screen. They also help ensure that the correct information is stored, and eliminate several files that have to be stored somewhere.

CMS- Centers for Medicare and Medicaid Services. It is a federally funded program that works with state governments to provide and administer both the Medicare and Medicaid programs. These programs work to provide health care to the elderly and the poor.

The most important part of the CMS is that it extends health care coverage to those who need it and may not have access to it as long as they are within the eligibility categories. Poor people who cannot afford health care have access to a physician as well as the elderly who may not be able to work any longer. It also allows those with long term disabilities to have coverage as they do not have access to work either. These services reimburse hospitals and physicians for services provided to individuals under their care which is important as well.

CMS-1500- Is a standard paper for claim that is used by health care professionals or suppliers to bill Medicare. It is a billing document submitted by health care providers for services, such as those provided by a physician's office. It is a standardized claim form developed and overseen by the National Uniform Claim Committee (NUCC). It has been adopted by the federal government and has become the standard for noninstitutional provider's claims. It is a request for payment from Medicare for services provided.

The most important part of the CMS-1500 is that it is standardized, allowing for the elimination of confusion on both ends of the form. The interpretation on either end should be the same. This is extremely important because documents that are submitted incorrectly impede reimbursements if not cancels them out overall.

CPT- Current procedural terminology. It is a document published and copyrighted every year by the American Medical Association (AMA). It provides a uniform set of language that is used to describe medical and surgical services. It is used as a major component of health care common procedure coding systems (HCPCS). It is standard for physician offices, outpatient,

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