Account Show Accreditation Adjudication Administrative
Adjustment Advanced Beneficiary Notice (ABN) Advance Directive Aging Allowed Amount Ambulatory Care Amount Not Covered Ancillary
Services Appeal Applied to Deductible Assignment of Benefits Authorization Number Bad Debt Balance Bill Beneficiary Benefits
Billed Charges Birthday Rule Case Management Charity Care Claim Clean Claim COBRA Insurance Coding
Coinsurance Coinsurance Days (Medicare) Concurrent Review Contractual
Adjustment Coordination of Benefits (COB) Co-Payment/Co-Pay Covered Benefit Covered Days Covered Services Deductible Dependents
Description of Service Diagnosis Code Diagnosis Related Group (DRG) Diagnostic Tests Edits Electronic Claim Electronic Data Interchange (EDI) Electronic Remittance Advice Elective
Eligible Payment Amount Eligibility Verification Evaluation and Management Services Evidence of Coverage (EOC) Experimental Procedures Explanation of Benefits
(EOB) Financial Counselors Fiscal Intermediary (FI) Flexible Spending Account (FSA) Flexible Spending Account (FSA) Global Period
Group Number Guarantor HCPC Codes HIPAA Independent Practice Association (IPA) Try searching under another name. Try searching under another name. Lifetime Maximum Maximums Medi-Cal Medical Group Medi-Cal Managed Care Medically Necessary Medical Record Number Medicare Medicare Part A Medicare Part B Medicare Part C/ Medicare Advantage Plans Medicare Part D Medigap Modifiers National Drug Code (NDC) National Provider Identifier Network Non-Billable Service Non-Covered Charges Non-Participating Provider/Out-of-Network Provider Out of Network Out of Network Benefits Out of Pocket Out of Pocket Maximum Participating Provider
Patient Liability Payment Arrangements Preferred Provider Organization PCIP Point of Service (POS) Plan Policy Number
Pre-Certification Pre-Certification Number Pre-Existing Condition Premium Preventive Care Primary Insurance Primary Care Physician (PCP) Primary Plan Prior Authorization Professional Component Provider Provider Network Try searching under another name. Referral Reimbursement Relative Value Unit (RVU) Remittance Advice (R/A) Resource-Based Relative Value Scale (RBRVS) Responsible Party/Guarantor Revenue Code Secondary Coverage Secondary Insurance Second Opinion Second Surgical Opinion (SSO) Self-Pay Service Area Share of Cost (SOC – Medi-Cal) Subscriber Supplemental Insurance Company TAR Technical Component Third Party Liability (TPL) Third Party Liability Form Unbundling Urgent Care Usual, Customary, and Reasonable (UCR) Utilization Management Try searching under another name. Well Baby/Well Child Care Wellness Program Try searching under another name. Try searching under another name. Try searching under another name. What is it called when a patient pays a set amount of money for their medication quizlet?Formulary. What is it called when a patient pays a set amount of money for their medication. Co-pay. A joint government program that helps with medical costs for those who fall under the national poverty level is called what. Medicaid.
What is the term used by the insurance industry that refers to the process of paying?1 / 50. What is the term used by the insurance industry that refers to the process of paying, denying, and adjusting claims based on patients' health insurance coverage benefits? a. Reimbursement.
Which term is the amount a pharmacy pays for a drug?Although costs vary depending on where you shop, three factors determine the price of prescription drugs: The Drug Ingredient Cost is the amount a pharmacist pays to buy the drug. A Pharmacy Mark-Up refers to any additional amount a pharmacist may charge for a drug, above the original drug cost.
What is the role of thirdThird-party payers are organizations that contract to pay some or all of a patient's healthcare expenses provided by healthcare professionals. They help reduce costs by limiting payments for some services and requiring patients to make co-payments for some services.
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