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Billing & Coding MNT

To help understand terminology related to Billing/Coding for MNT

TermDefinition
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.
Created by: duckey658