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Medical Insurance
| Question | Answer |
|---|---|
| AFDC | Aid to families with dependent children |
| CC | Chief complaint, the main reason for today's visit. |
| EOMB | Explanation of medicare benefits |
| Coding | Process of assigning numerical code to a diagnosis and procedure or treatment |
| Diagnosis/DX | Physicians opinion of a patients illness or injury |
| Tx | Treatment |
| Premium | The amount of money paid to an insurance company for an insurance plan |
| Benefit | The amount of money an insurance carrier pays for services covered |
| Schedule of Benefits | A list of benefits that an insurance company will pay |
| Dependents | The spouse, children, and sometimes domestic partner or other individuals designated by the insured who are covered under a healthcare plan |
| Subscriber | The person who buys an insurance plan |
| SOB | Schedule of Benefits |
| OV | Office Visit |
| Referral | Transfer of patients specified care from physician to another |
| FICA | Federal insurance contribution act |
| SSI | Supplemental security income |
| PT | Patient |
| Established Patient | Patient has seen the physician within the past 3 years. |
| New Patient: | A patient not seen by the physician within the past 3 years |
| Outpatient | A patient who receives care at a medical facility but who inst admitted to the facility overnight, or for 24 hours or less |
| Inpatient | a person admitted to a hospital for at least 24 hours |
| Consultation | Service provided so that the physician can give advice to another physician about a patient |
| UCR | Usual, customary, and reasonable fees. |
| UPIN | Unique physician identifier number |
| EOB | Explanation of benefits |
| ICD | International classification of diseases |
| CPT | Current, procedural terminology |
| Reimbursement | Receiving payment for services rendered. |
| Assignment of Benefits | Permission given by the insured that allows the insurance to pay directly to the physician. |
| Exclusions | Situations that arent covered by the health insurance policy such as self inflicted injury |
| Network | The group of doctors, hospitals and other health care providers that insurance companies contract with to provide services at discounted rates. |
| Out of Network Provider | A health care professional, hospital or pharmacy that’s not part of a health plan's network of preferred providers. |
| Grace Period | A time period after the payment is due, in which the policy holder may make a payment without penalty. |
| Claim | A request by a plan member or a plan members health care provider for the insurance company to pay for medical services. |
Created by:
zainabgelle
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