Question | Answer |
Exclusion | Provisions written into contract denying coverage or limiting the scope of coverage |
Waiting Period | Period of time where insurance is not in effect or that certain diagnosis may not be covered. |
Medicare | People that are older than 65. Sponsored by the federal government. |
Medicaid | Sponsored by the federal, state and local governments. Provides health care to people on welfare, disabled. |
Reimbursement Cycle | The process from start to finish used to collect money in the physician office. |
Balance | Amount owed on a debit transaction; |
Patient Registration Form | Used to collect personal data and essential facts about their insurance. |
Encounter Form | An all-encompassing billing form personalized to the practice of the physician. Used when patient submits an insurance billing. |
Assignment | A transfer, after an event insured against, or an individual's legal right to collect an amount payable under an insurance contract. |
CHAMPVA | Federal program that covers medical expenses of spouses and children of veterans with total, permanent, service connected disabilities. |
TRICARE | a government sponsored program that provides hospital and medical services for dependents of active or retired service personnel. |
Unemployment Compensation Disability Insurance | Covers off the job injury or sickness that is paid by the deductions from a person's paycheck. |
(RA) Remittance Advice | Describes services billed and how payment was determined. Used by Medicare/Medicaid. |
Provider | physician or organization that has a contractual agreement with an insurance plan. |
Day Sheet | A register for recording daily business transactions. |
Accounts Receivable | The total amount of money owed for professional services rendered. |
(EOB) Explanation of Benefits | Gives an explanation of services billed and includes a breakdown of how the payment was determined. |