#1
What does EDI stand for in the context of Healthcare Administration?
Electronic Data Interchange
ExplanationStandardized electronic exchange of healthcare data
#2
Which of the following is NOT a benefit of Electronic Data Interchange (EDI) in healthcare?
Higher cost for transactions
ExplanationIncreased transaction efficiency and reduced costs
#3
What is the primary purpose of a claim in healthcare EDI?
To request payment for healthcare services provided
ExplanationRequests reimbursement for healthcare services rendered
#4
What is a remittance advice in healthcare EDI?
Explanation of benefits
ExplanationProvides details of payments made
#5
Which of the following is NOT a type of healthcare EDI transaction?
802.11
ExplanationWireless networking standard, not related to healthcare transactions
#6
In healthcare, what does HIPAA stand for?
Health Insurance Portability and Accountability Act
ExplanationRegulates the use and disclosure of protected health information
#7
Which of the following is a key component of healthcare EDI?
HL7
ExplanationStandard for exchanging healthcare information electronically
#8
Which standard is commonly used for EDI transactions in healthcare?
ANSI X12
ExplanationDefines the structure for electronic data interchange
#9
What is a 837 file used for in healthcare EDI?
Healthcare claim
ExplanationStandard format for submitting healthcare claims electronically
#10
Which organization is responsible for enforcing HIPAA regulations in the United States?
HHS
ExplanationDepartment of Health and Human Services
#11
What is the purpose of a 270 transaction in healthcare EDI?
Eligibility inquiry
ExplanationVerifies patient's insurance eligibility
#12
Which of the following is a potential challenge of implementing EDI in healthcare?
Integration with legacy systems
ExplanationCompatibility with existing technology
#13
What role does a clearinghouse play in healthcare EDI?
Verifying insurance eligibility
ExplanationEnsures accurate and efficient processing of claims
#14
What does the term '837P' refer to in healthcare EDI?
Professional (Healthcare Claim)
ExplanationUsed for professional healthcare claims
#15
What is the purpose of the 837I transaction in healthcare EDI?
Institutional (Healthcare Claim)
ExplanationUsed for institutional healthcare claims
#16
What is the purpose of the 278R transaction in healthcare EDI?
Referral authorization
ExplanationAuthorizes referral to specialists or services