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Billing & Coding MNT
To help understand terminology related to Billing/Coding for MNT
Term | Definition |
---|---|
advance beneficiary notice | may also be known as waiver of liability. A notice health care provider and supplier are required to give and have signed by an insured to person and insurance care will not cover these services or items |
authorization | a referral that has been submitted to the patient's insurance company for approval for the services requested to be performed. |
benefit period | the specified period of time during which charges for covered services must be incurred in order to be eligible for payment by a third party payer/ |
claim | A request for payment for service(s) provided by a health care provider. |
CMS | Federal agency within the US Dept. of Health and Human Services that administers the Medicare program and Medicaid. |
Council for Affordable Quality Healthcare | A non-profit alliance of health plans and trade associations which allows industry collaboration to simplified healthcare administration. |
Current Procedural Terminology | descriptive list of terms and numeric codes used for reporting diagnostic and therapeutic procedures and medical services. |
Employer Identification Number (EIN) | Used to identify a business entity |
ICD-10 | WHO uses to report morbidity and mortality information. |
Medicaid | Federally-funded insurance for low-income adults, their children and people with certain disabilities. |
Medicare Part A | often called "hospital insurance" |
Medicare Part B | often insurance for outpatient medical services |
Medicare Part D | covers prescription drugs. |
NPI | a universal number assigned to a provider that identifies them as a provider of services to the treatment. Unique, government-issued. |
Superbill | contains vital information about the professional providing the health care service. A client can submit the bill directly to the health care insurer for payment to the insured. |