#1
What does EDI stand for in healthcare?
Electronic Data Interchange
ExplanationIt stands for Electronic Data Interchange, facilitating electronic communication and data exchange in healthcare.
#2
Which of the following is a benefit of using EDI in healthcare billing and claims?
Reduced errors
ExplanationEDI in healthcare reduces errors, ensuring more accurate billing and claims processing.
#3
What is a 837 file format commonly used for in healthcare EDI?
Claims submission
ExplanationThe 837 file format is widely used for electronic claims submission in healthcare EDI.
#4
Which organization oversees the HIPAA-mandated standard transactions for EDI in healthcare?
CMS (Centers for Medicare & Medicaid Services)
ExplanationCMS oversees the standard transactions mandated by HIPAA for EDI in healthcare.
#5
Which of the following is NOT a commonly used healthcare EDI transaction type?
404
Explanation404 is not a commonly used healthcare EDI transaction type.
#6
What does the 270/271 transaction set in healthcare EDI entail?
Claim status inquiry and response
ExplanationThe 270/271 transaction set in healthcare EDI involves claim status inquiry and response.
#7
Which EDI standard is widely used in the United States for healthcare transactions?
ANSI X12
ExplanationANSI X12 is the widely used EDI standard in the United States for healthcare transactions.
#8
Which of the following is a potential challenge of implementing EDI in healthcare?
Standardization of data formats
ExplanationA potential challenge of implementing EDI in healthcare is the standardization of data formats.
#9
What is the purpose of the 835 file format in healthcare EDI?
Payment and remittance advice
ExplanationThe 835 file format in healthcare EDI serves the purpose of payment and remittance advice.
#10
What is a key advantage of using XML-based formats in healthcare EDI?
Human readability
ExplanationXML-based formats in healthcare EDI offer the advantage of human readability.
#11
In the context of healthcare EDI, what does the term 'clearinghouse' refer to?
An intermediary for processing and routing transactions
ExplanationIn healthcare EDI, a clearinghouse is an intermediary for processing and routing transactions.
#12
What is the primary purpose of the 834 file format in healthcare EDI?
Benefits enrollment and maintenance
ExplanationThe primary purpose of the 834 file format in healthcare EDI is benefits enrollment and maintenance.
#13
Which organization is responsible for creating and maintaining the X12 standards for EDI in the United States?
Accredited Standards Committee X12 (ASC X12)
ExplanationThe Accredited Standards Committee X12 (ASC X12) is responsible for creating and maintaining the X12 standards for EDI in the United States.
#14
What is the purpose of the 999 transaction in healthcare EDI?
To report errors in a submitted transaction
ExplanationThe 999 transaction in healthcare EDI is used to report errors in a submitted transaction.