Write-Off

Worker’s Compensation

V-Codes

Utilization Review (UR)

Utilization Limit

Usual Customary and Reasonable (UCR)

Unique Physician Identification Number (UPIN)

Upcoding

Untimely Submission

Unbundling

UB04

TRICARE

Type of Service (TOS)

Triple Option Plan (TOP)

Tax Identification Number (TIN)

Third Party Administrator (TPA)

Tertiary Insurance Claim

Term Date

Taxonomy Code

Treatment Authorization Request (TAR)

Supplemental Insurance

Superbill

Subscriber

Specialist

Software as a Service (SAAS)

Signature on File (SOF)

Skilled Nursing Facility

Security Standard

Secondary Procedure

Secondary Insurance Claim

Self-Pay

Self-Referral

Scrubbing

Relative Value Amount (RVA)

Revenue Code

Responsible Party

Remittance Advice (R/A)

Referral

Provider Transaction Access Number (PTAN)

Provider

Privacy Rule

Premium

Pre-exisiting Condition Exclusion

Pre-existing Condition (PEC)

Pre-determination

Pre-Certification

Preauthorization

Practice Management Software

Preferred Provider Organization (PPO)

Place of Service Code

Point of Service Plans

Primary Care Physician (PCP)

Patient Responsibility

Palmetto GBA

Outpatient

Out-of-Network

Office of Inspector General (OIG)

National Provider Identifier (NPI) Number

Not Otherwise Specified (NOS)

Non-participation

Network Provider

Not Elsewhere Classifiable (NEC)

Non-Covered Charge (N/C):

Modifier

Medigap

Medicaid

Medicare Donut Hole

Medicare Coinsurance Days

Medicare

Medical Transcription

Medical Savings Account (MSA)

Medicare Secondary Payer

Medical Record Number

Medical Necessity

Medical Billing Specialist

Medical Coder

Medical Assistant

Maximum Out of Pocket

Managed Care Plan

Medicare Administrative Contractor (MAC)

Intensive Care

Independent Practice Association (IPA)

Inpatient

In-Network

Indemnity

Incremental Nursing Charge

ICD-10 Codes

ICD-9 Codes

Hospice

Health Maintenance Organization (HMO)

Health Insurance Portability and Accountability Act (HIPAA)

Health Insurance Claim

Healthcare Reform Act

Healthcare Provider

Healthcare Insurance

Healthcare Financing Administration Common Procedure Coding System (HCPCS)

Healthcare Financing Administration

Guarantor

Group Number

Group Name

Group Health Plan (GPH)

Fraud

Formulary

Fiscal Intermediary (FI)

Financial Responsibility

Fee Schedule

Fee for Service

ERISA

Electronic Remittance Advice (ERA)

Explanation of Benefits (EOB)

Enrollee

Electronic Medical Records (EMR)

Evaluation and Management (E/M)

Electronic Funds Transfer

Electronic Claim

Dx

Duplicate Coverage Inquiry (DCI)

Downcoding

Date of Birth (DOB)

Durable Medical Equipment (DME)

Demographics

Deductible

Day Sheet

Date of Service (DOS)

Crossover Claim

Credit Balance

Credentialing

Current Procedural Technology (CPT) Code

Co-Pay

Coordination of Benefits (COB)

Contractual Adjustment

Collection Ratio

Co-Insurance

COBRA Insurance

Coding

CMS 1500

Centers for Medicare and Medicaid Services (CMS)

Clearinghouse

Clean Claim

Charity Care

Civilian Health and Medical Program of Uniform Services (CHAMPUS)

Capitation

Blue Cross Blue Shield

Beneficiary

Authorization

Application Service Provider (ASP)

Assignment of Benefits (AOB)

Applied to Deductible (ATD)

Appeal

Ancillary Services

Aging

American Medical Association (AMA)

Allowed Amount