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MEDI SOFT
TERMINOLOGY
| Question | Answer |
|---|---|
| FEE FOR SERVICE | HEALTH PLAN THAT REPAYS THE POLICYHOLDER FOR COVERED MEDICAL EXPENCES |
| PPO | MANAGED CARE NETWORK OF HEALTH CARE PROVIDERS WHO AGREE TO PERFORM SERVICES FOR PLAN MAMBERS AT DISCOUNTED FEES. |
| HMO | A MANAGED HEALTHCARE SYSTEM IN WHICH PROVIDERS AGREE TO OFFER HEALTH CARE TO THE ORGANIZATION'S MAMBERS TO FIXED PERIODIC PAYMANTS FROM THE PLAN |
| ADJUDICATION | SERIES OF STEPS THAT DETERMINE WHETHER A CLAIM SHOULD BE PAID |
| REMITTANCE ADVICE (RA) | AN EXPLANATION OF BENIFITS TRANSMITTED ELECTRONICALLY BY A PAYER TO A PROVIDER |
| ACCOUNTS RECEIVABLE (AR) | MONIES THAT ARE FLOWING INTO A BUSINESS |
| ELECTRONIC MEDICAL RECORDS (EMR) | THE ELECTRONIC AND MANAGEMENT OF HEALTH INFORMATION |
| FEE FOR SERVICE | HEALTH PLAN THAT REPAYS THE POLICYHOLDER FOR COVERED MEDICAL EXPENCES |
| PPO | MANAGED CARE NETWORK OF HEALTH CARE PROVIDERS WHO AGREE TO PERFORM SERVICES FOR PLAN MAMBERS AT DISCOUNTED FEES. |
| HMO | A MANAGED HEALTHCARE SYSTEM IN WHICH PROVIDERS AGREE TO OFFER HEALTH CARE TO THE ORGANIZATION'S MAMBERS TO FIXED PERIODIC PAYMANTS FROM THE PLAN |
| ADJUDICATION | SERIES OF STEPS THAT DETERMINE WHETHER A CLAIM SHOULD BE PAID |
| REMITTANCE ADVICE (RA) | AN EXPLANATION OF BENIFITS TRANSMITTED ELECTRONICALLY BY A PAYER TO A PROVIDER |
| ACCOUNTS RECEIVABLE (AR) | MONIES THAT ARE FLOWING INTO A BUSINESS |
| ELECTRONIC MEDICAL RECORDS (EMR) | THE ELECTRONIC AND MANAGEMENT OF HEALTH INFORMATION |
| SPONSER | IN TRICARE, THE ACTIVE DUTY SERVICE MEMBER |
| REFERRING PROVIDER | A PHYSICIAN WHO RECOMMENDS THAT A PATIENT MAKE AN APPOINTMENT WITH A PARTICULAR DOCTOR |
Created by:
DELONI
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