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Insurance Billing
Insurance Billing YCST Chapter Four Terms and Abbreviations
| Question | Answer |
|---|---|
| CC | Chief complaint or complication/comorbidity |
| Dx | Diagnosis |
| ED or ER | Emergency department or Emergency room |
| EHR | Electronic Health Record |
| EMR | Electronic Medical Record |
| FH | Family history |
| HIM | Health Information Management |
| HPI | History of Present Illness |
| ICU | Intensive Care Unit |
| LLQ | Left lower quadrant |
| LUQ | Left upper quadrant |
| MDM | Medical Decision Making |
| NP | New patient |
| PCP | Primary Care Physician |
| PE or PX | Physical Examination |
| PFSH | Past family and social history |
| PH | Past history |
| RCU | Respiratory care unit |
| RLQ | Right lower quadrant |
| R/O | Rule out |
| ROS | Review of Systems |
| RUQ | Right upper quadrant |
| SH | Social history |
| SOAP | Subjective, objective, assessment, plan |
| WNL | Within normal limits |
| What is a medical condition that runs a short but relatively severe course? | Acute |
| What is a patient's statement describing symptoms, problems, or conditions as the reason for seeking health care services from a physician? | Chief complaint |
| What is a medical condition persisting over a long period of time? | Chronic |
| What is an ongoing condition that exists along with the condition for which the patient is receiving treatment? | Comorbidity |
| What is the provision of similar services to the same patient by more than one physician on the same day? | Concurrent care |
| What are services rendered by a physician whose opinion or advice is requested by another physician or agency in the evaluation or treatment of a patient's illness or suspected problem? | Consultation |
| Who is a provider whose opinion or advice about evaluation or management of a specific problem is requested by another physician? | Consulting physician |
| What is it when a physican sees a patient who has received treatment for a condition and is referred by the previous doctor for treatment of the same condition? | Continuity of care |
| What is a chronologic detailed recording of pertinent facts and observations about a patient's health as seen in chart notes and medical reports? | Documentation |
| What is a patient record that is created using a computer with software? | EHR |
| Who is an individual who has received professional services within the past three years from the physician or another physician of the same specialty who belongs to the same group practice? | Established patient |
| What is the performance of services and procedures that are consistent with the diagnosis in accordance with standards of good medical practice, performed at the proper level, and provided in the most appropriate setting? | Medical necessity |
| Who is an individual who has not received any professional services from the physician or another physician of the same specialty who belongs to the same group practice within the past three years? | New patient |
| Who is the physician ordering nonphysician services for a patient when an insurance claim is submitted by a nonphysiian supplier of services? | Ordering physician |
| Who is a physician who oversees the care of patients in a managed health care plan and refers patients to see specialists for services as needed? | PCP |
| What is the process of going over financial documents before billing is submitted to the insurance company to determine documentation deficiencies and errors? | Prospective review |
| What is the transfer of the total or specific care of a patient from one physician to another? | Referral |
| Who is a physician who sends the patient for testing or treatment noted on the insurance claim when it is submitted by the physicain performing the service? | Referring physician |
| What is the process of going over financial documents after billing an insurance carrier to determine documentation deficiences and errors? | Retrospective review |
Created by:
dsljulian
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