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insurance term

insurance terms.

accounts receivable a term used to describe money coming into a business.
capitation a payment made to a health plan by a policyholder for coverage.
coinsurance under an insurance plan, the portion or percentage of the charges that the patient is responsible for paying.
diagnosis physicians opinion of the nature of the patients illness or injury.
encounter form AKA "super bill." a form listing procedures relevant to the specialty of a medical office used to record the procedures.
health maintenance organization a type of managed care system in which providers are paid fixed rates at regular intervals.
health plan a plan, program, or organization that provides health benefits.
managed care a type of insurance in which the carrier is responsible for the financing and delivery of health care.
patient information form a document that contains personal, employment, and medical insurance information about the patient.
preferred provider organization (PPO) a network of health care providers who agree to provide services to a plan members at a discounted fee.
premium a fixed amount that is paid to a provider in advance to provide medically necessary services to patients.
auto posting an automated process for entering information on a remittance advice into a computer.
HIPPA federal act that set guidelines for standardizing the electronic data interchange of admin. and financial trans. exposing frauds and abuse in government programs and protection security and privacy of health care.
electronic medical record (EMR) electronic collection and managment of health data.
electronic data interchange (EDI) the exchange of routine business transactions from one computer to another using publicly available communications protocols.
electronic funds transfer (EFT) a system that transfers money electronically.
information technology (IT) development managment and support of computer based hardware and software systems.
National provider identifier (NPI) a standard identifier for all health care providers consisting of ten numbers.
walkout statement a document listing charges and payments that is given to a patient after an office visit.
Created by: jennaking21