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NHA

CBCS-STUDY TERMS FOR CERTIFIED BILLING AND CODING SPECIALIST

QuestionAnswer
ACCOUNTS RECEIVABLE DEPARTMENT MANAGES THE BILLING PROCESS FOR THE PROVIDERS- BILLING PROCESS, TRACKS PATIENTS SERVED BUT NOT PAID, MANAGES CHARGE DESCRIPTION MASTER
EXPLANATION OF BENEFITS (EOB) DESCRIBES THE SERVICES RENDERED, PAYMENT COVERED AND BENEFIT LIMITS AND DENIALS
AGING REPORTS ATB- AGE TRAIL BALANCE- STATUS OF INVOICE, WAIT FOR PAYMENTS
CHARGE DESCRIPTION MASTER (CDM) DESCRIPTION OF SERVICE, CPT CODE/HCPCD CODE, REVENUE CODE, CHARGE AMT, SERVICE CODE, GENERAL LEDGER KEY, ACTIVITY, STATUS DATE
ACCOUNT NUMBER NUMBER THAT IDENTIFIES SPECIFIC EPISODE OF CARE, DATE OF SERVICE, OR PATIENT
HEALTH RECORD NUMBER NUMBER THE PROVIDER USES TO IDENTIFY AN INDIVIDUAL PATIENT'S RECORD
MEDICARE SUMMARY NOTICE (MSN)
SUBSCRIBER PURCHASER OF THE INSURANCE OF THE MEMBER OF GROUP FOR WHICH AN EMPLOYER OR ASSOCIATION AS PURCHASED INSURANCE
SUBSCRIBER NUMBER UNIQUE CODE USED TO IDENTIFY A SUBSCRIBER'S POLICY
COST SHARING THE BALANCE THE POLICYHOLDER MUST PAY TO THE PROVIDER
BATCH A GROUP OF SUBMITTED CLAIMS
BALANCE BILLING BILLING PATIENTS FOR CHARGES IN EXCESS OF THE MEDICARE FEE SCHEDULE
NOTICE OF EXCLUSIONS FROM MEDICARE BENEFITS NOTIFICATION BY THE PHYSICIAN TO A PATIENT THAT A SERVICE WILL NOT BE PAID
ADVANCE BENEFICIARY NOTICE OF NON COVERAGE
RECONCILIATION
WRITE OFF THE DIFFERENCE BETWEEN THE PROVIDER'S ACTUAL CHARGE AND THE ALLOWABLE CHARGE
REVENUE CYCLE
MEDICAL NECESSITY THE DOCUMENTED NEED FOR A PARTICULAR MEDICAL INTERVENTION
REMITTANCE ADVICE (RA) THE REPORT SENT FROM THE 3RD PARTY PAYER TO THE PROVIDER THAT REFLECTS ANY CHANGES MADE TO THE ORIGINAL BILLING
ADJUDICATION
CLAIM CONTROL NUMBER
NCCI EDITS
PATIENT LEDGER ACCOUNT
DENIAL
BAD DEBT
LIFE CYCLE OF A CLAIM
PROSPECTIVE BILLING ACCOUNT AUDIT
RECOVERY AUDIT CONTRACTOR (RAC)
Created by: LISA AJALA
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