Terms : Hide Images
| 4953212618 | MCR | medicare | 0 | |
| 4953212619 | MCD | medicaid | 1 | |
| 4953215818 | allowed amount | the amount deemed appropriate to pay for svcs rendered by an ins company | 2 | |
| 4953225743 | Part A | covers hospital | 3 | |
| 4953229845 | Part B | covers outpt services or ov's | 4 | |
| 4953232924 | Part C | advantage care | 5 | |
| 4953235030 | Part D | covers prescription | 6 | |
| 4953252302 | in pt. | in patient, person spending the night at a hospital | 7 | |
| 4953256105 | out pt. | out patient, person not spending the night in a hospital | 8 | |
| 4953266393 | CPT-4 | current procedural terminology fourth edition | 9 | |
| 4953269548 | ICD-9 | international classification of diseases nineth edition | 10 | |
| 4953274337 | ICD-10 | international classification of diseases tenth edition | 11 | |
| 4953316221 | capitation | a set fee paid to the physician whether patients are seen or not | 12 | |
| 4953365305 | policy holder, subscriber, guarantor, insured, member | terms that refer to a person who holds insurance | 13 | |
| 4953367386 | PPO | preferred provider organization | 14 | |
| 4953373315 | HMO | health maintenance organization | 15 | |
| 4953376764 | EPO | exclusive provider organization | 16 | |
| 4953381726 | quality assurance | certificates, licenses, diplomas held by personnel to perform their jobs efficiently | 17 | |
| 4953395511 | medi medi | persons who have both MCR & MCD insurances | 18 | |
| 4953408244 | utilization review | method controlling healthcare costs and quality of care by reviewing necessity | 19 | |
| 4953413054 | necessity | the linkage and supported procedure and diagnosis codes | 20 | |
| 4953431331 | PCP | primary care physician or provider | 21 | |
| 4953438927 | IDS | integrated delivery system | 22 | |
| 4953446491 | PAR | participating provider | 23 | |
| 4953446492 | NON-PAR | non-participating provider | 24 | |
| 4953449502 | exclusion | insurance not covering procedures that are not found necessary | 25 | |
| 4953456615 | POS | point of service, or place of service | 26 | |
| 4953458877 | TOS | type of service | 27 | |
| 4953461611 | DOA | dead on arrival or date of accident | 28 | |
| 4953463558 | N.F. | no fault | 29 | |
| 4953463592 | O.V. | office visit | 30 | |
| 4953466293 | Est. Pt. | established patient (more than one visit) | 31 | |
| 4953469694 | Consult | seeing a specilist | 32 | |
| 4953475438 | TOP | is aka Cafeteria Plan, where one of the three types of ins is selected: HMO, PPO, EPO | 33 | |
| 4953480773 | dirty claim | claim with errors, omissions, mistakes, fraudulant information | 34 | |
| 4953490655 | clean claim | claim form with correct information that will be bill and processed | 35 | |
| 4953497355 | claim submission | sending a claim out via electronically or via mail | 36 | |
| 4953504275 | submission time | 30, 90 or 120 days | 37 | |
| 4953509780 | MCR coverage | 80% | 38 | |
| 4953509781 | Primary Ins | insurance that covers most of medical cost | 39 | |
| 4953514027 | Secondary Ins | aka co-insurance picks up where primary left off | 40 | |
| 4953517842 | Tertiary Ins | picks up, where secondary ins left off | 41 | |
| 4953533453 | cms-1500 form | form used to submit | 42 | |
| 4991046935 | WC | workers' compensation | 43 | |
| 4991048784 | PAC | preadmission certification | 44 | |
| 4991051874 | concurrent review | review of medical necessity of tests and procedures, ordered as a inpt hospitalization | 45 | |
| 4991060772 | birthday rule | method used to determine a child dependent who's ins is her primary vs secondary based on parents birthday | 46 | |
| 4991067537 | superbill | is aka encounter form- has commonly used CPT4 and ICD10 codes and some prices | 47 | |
| 4991074003 | copayment | small fee paid upon every o.v. | 48 | |
| 4991076429 | consult | being seen by a specialist | 49 | |
| 4991078944 | demographics | term used to describe all pt. information | 50 | |
| 4991081922 | writeoff | taking a financial hit, by adjusting the account to zero | 51 | |
| 4991087199 | fee-for-service | physician charges a price for every service performed | 52 | |
| 4991092854 | case management | development of pt. care plans for the coordination and provision of care for complicated cases in a cost effective manner. | 53 | |
| 4991103066 | quality control | is guidelines ensuring the best medical care by making sure all equipment is in good working order | 54 | |
| 4991113735 | NP | new patient (first time to a practice) | 55 | |
| 4991115880 | NF | no fault (car accident) | 56 | |
| 4991119672 | A/R | accounts receivable "monies made/earned" | 57 | |
| 4991122490 | A/P | accounts payable "monies owed" | 58 | |
| 4991129360 | gatekeeper | providing essential healthcare service at the lowest possible cost | 59 | |
| 4991132430 | MCO | managed care organization (help to control healthcare costs) | 60 | |
| 6169364610 | open claim | organized by mth and ins. co. and have been submitted to the payer but await processing | 61 | |
| 6169366923 | malignant | cancerous, spreading, harmful cancer | 62 | |
| 6169367301 | benign | non-cancerous, not spreading | 63 | |
| 6169369018 | eponym | a dz, condition, disorder, and instrument or procedure named after a person | 64 | |
| 6169372763 | reference terms | are placed to assist the coder in finding the proper codes | 65 | |
| 6169374046 | CPT-4 book | has 6 sections excluding the index | 66 | |
| 6169394730 | C.O.B. | coordination of benefits | 67 | |
| 6169396368 | E/M | evaluation and management | 68 | |
| 6169398748 | HIPAA | privacy act | 69 | |
| 6169399134 | EHR | electronic health record | 70 | |
| 6169399865 | EMR | electronic medical record | 71 | |
| 6169400568 | ER | emergency | 72 | |
| 6169402799 | BCBS | blue cross blue shield | 73 | |
| 6169404338 | N.H. | Nursing home | 74 | |
| 6169406319 | S.O.F. | signature on file | 75 | |
| 6169408060 | MCO | Managed care organization | 76 | |
| 6169408541 | NEC | Not Elsewhere Classified | 77 | |
| 6169409651 | NOS | Not otherwise Specified | 78 | |
| 6169410269 | P.F. | problem focused | 79 | |
| 6169411432 | E.F. | expanded focused | 80 | |
| 6169411955 | Low | 20-30 (low complexity) | 81 | |
| 6169412378 | Mod | 30-45 (moderate complexity) | 82 | |
| 6169414586 | High | 45-1hr (high complexity) | 83 | |
| 6169415586 | C.C.U | critical care unit or cardiac care unit | 84 | |
| 6224663244 | E.O.B | explanation of benefits | 85 | |
| 6224667984 | Discharge | being released from the hospital | 86 | |
| 6224668631 | Admission | being admitted to the hospital | 87 | |
| 6225065445 | Day sheet | monies collected for the day at a doctor's office | 88 | |
| 6225066908 | Aging Report | a list of open or overdue amounts on patient or insurance accounts | 89 | |
| 6225069991 | past medical hx | all the patients health statuses from birth to present date | 90 | |
| 6225072181 | icd9 vs icd10 | icd9 has 3-5 digits, icd10 has 10 characters | 91 |
