Health Ins and Claims-Chapter 4
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| show | accept assignment
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| the amount owed to a business for services or goods provided | show 🗑
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| the maximum amount the payer will reimburse for each procedure or service, according to the patient's policy | show 🗑
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| show | appeal
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| show | assignment of benefits
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| show | claims adjudication
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| show | claims processing
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| the transmission of claims data (electromically or manually) to payers or clearinghouses for processing | show 🗑
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| a correctly completed standarized claim | show 🗑
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| show | clearinghouse
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| also called coinsruance paymetn; the percentage the patient pays for covered services after the deductible has been met and the copayment has been paid | show 🗑
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| abstract of all recent claims filed on each patient | show 🗑
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| provision in group health insurance policies that prevents multiple insurers from paying benefits covered by other polcies; also specifies that coverage will be provided in a specific sequence when more than one policy covers the claim | show 🗑
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| also called manual daily accounts receivable journal; chronologically summary of all transactions posted to individual patient ledgers/accounts on a specific day | show 🗑
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| show | deductible
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| show | electronic remittance advice (ERA)
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| show | encounter form
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| person responsible for paying health care fees. | show 🗑
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| contracts with a health insurance plan and accepts whatever the plan pays for procedures or services performed | show 🗑
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| also called patient account record; a computerized permanent record of all financial transactions between the patient and the practice | show 🗑
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| any medical condition that was diagnosed and/or treated within a specified period of time immediately preceding the enrollee's effective date of coverage | show 🗑
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| show | superbill
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| submitting multiple CPT codes when one code should be submitted | show 🗑
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