medical billing chapter 1 part 1
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Accounting cycle | flow of financial transactions in a business
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Accounts receivable (AR) | term used to describe money coming in to a business
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Capitation | a fixed amount that is paid to a provider in advance to provide medically necessary services to patients
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Coinsurance | Under an insurance plan, the portion or percentage of the charges that the patient is responsible for paying
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Co-payment | a small fixed fee paid by the patient at the time of an office visit
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Diagnosis code | a value that stands for a patient's illness, signs, or symptoms
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Encounter form | a form listing procedures relevant to the specialty of a medical office, used to record the procedures
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Explanation of beneifts (EOB) | document form a health plan that list the amount of a benefit and explains how it was determined
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Fee-for-service | insuramce plan in which policyholders are reimbursed for health care cost
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Health maintenance organization (HMO) | type of managed care system in which providers are paid fixed rates at regular intervals
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Health plan | a plan, program, or organization that provides health benefits
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Managed care | a type of insurance in which the carrier is responsible for the financing and delivery of health care.
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Ploicy holder | individual who has contracted with a health plan for coverage.
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Preferred provider organization (PPO) | a network of health care providers who agree to provide services to plan members at a discounted fee
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Premium | payment made to a health plan by policyholder for coverage
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Procedure code | a number that represents medical procedures performed by aprovider
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Remittance advice (RA) | an electronic document from a health plan that lists the amount of benefit and explains how it was determined.
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