Medical Claims Terminology

Glossary of billing and insurance terms - Mayo Clinic

https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/glossary

Claims review is the review your insurer or health plan performs before paying your doctor or reimbursing you. This review allows the insurer to validate the medical appropriateness of the services given and review the charges related to your care. ... Current Procedural …

Medical Billing Vocabulary & Key Terms

https://www.medicalbillingandcoding.org/billing-vocabulary-key-terms/

3.02: Medical Billing Vocabulary & Key Terms. Like medical coding, the profession of medical billing has its own specific vocabulary. In this course, you’ll learn about some of the …

Glossary of Common Medical Claims Termonology

https://clearinghouses.org/medical-claims-mgmt/

Medical Claims 101: What You Need to Know - Definitive …

https://www.definitivehc.com/blog/medical-claims-101-what-you-need-to-know

A medical claim is a bill that healthcare providers submit to a patient’s insurance provider. This bill contains unique medical codes detailing the care administered during a patient …

Common Health Insurance Terms and Definitions | WPS

https://www.wpshealth.com/resources/customer-resources/health-insurance-terminology.shtml

Allowable charge—sometimes known as the "allowed amount," "maximum allowable," and …

List of CPT/HCPCS Codes | CMS - Centers for Medicare …

https://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/List_of_Codes

We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), …

Medical Billing and Coding Terminology | UMA

https://www.ultimatemedical.edu/blog/medical-billing-and-coding-terminology/

A medical billing specialist fills claims to insurance companies so that the provider can be paid. Medical coder. A medical coder is the person responsible for …

Glossary of Health Coverage and Medical Terms

https://www.cms.gov/CCIIO/Resources/Files/Downloads/dwnlds/uniform-glossary-final.pdf

Glossary of Health Coverage and Medical Terms. Page . 3. of . 4. Plan . A benefit your employer, union or other group sponsor provides to you to pay for your health care …

Medical Billing Terms A thru E - All Things Medical Billing

https://www.all-things-medical-billing.com/medical-billing-terms

Clean Claim – Medical billing term for a complete submitted insurance claim that has all the necessary correct information without any omissions or mistakes that allows it to be …

Common Health Insurance Terminology 101 - JDRF

https://www.jdrf.org/t1d-resources/living-with-t1d/insurance/common-health-insurance-terms/

Common Health Insurance Terminology 101. ... pharmacy or medical equipment supplier to include them in the plan’s network, they agree to specific amounts that will be paid for …