The Health Insurance Claim Forms Chapter 20

20 cards

Vocabulary Wo Rds From


 
  
Created Mar 10, 2010
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mzprofbabs

 

 
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1
assignment of benefits
 
The transfer of the patient's legal right to collect benefits for medical expenses to the provider...
2
audit
 
A process done prior to claims submission to examine claims for accuracy and completeness. ...
3
audit trail
 
the path left by a transaction when it has been completed; often referred to when tracking...
4
clean claims
 
insurance claim forms that have been completed correctly  (no errors or omissions) and...
5
clearinghouse
 
A centralized facility to which insurance claims are transmitted.  Clearing houses separate,...
6
direct billing
 
a method of electronic claims submission where computer software allows a provider to submit...
7
dirty claims
 
Claims that contain errors omissions which must be corrected and resubmitted to an insurance...
8
electronic claims
 
claims  that are submitted to insurance processing facilities using a computerized medium....
9
Electronic Data Interchange (EDI)
 
the transfer of data back and forth between two or more entities using an electronic medium
10
electronic ( or digital) signature.  
 
A scanned signature or other such mark that is accepted as proof of approval of and/or responsibility...
11
employer identification number (EIN)
 
the number used by the Internal REvenue Service that identifies a business or individual functioning...
12
incomplete claim
 
a claim that is missing information and is returned to the provider for correction and resubmission....
13
Intelligent Character Identifier (ICR)
 
the electronic scanning of printed items as images and use of special software to recognize...
14
National Provider Identifier (NPI)
 
a lifetime number consisting of 10 digits that Medicare will use to replace the Provider Identification...
15
paper claims
 
Hard copies of insurance claims that have been completed and sent by surface mail.
16
provider
 
any company, individual, or group that provides medical, diagnostic, or treatment services...
17
Provider Identification Numbers (PINs)
 
Number assigned to providers by a carrier for use in submission of claims.
18
Unique Provider Identification Number (UPIN)
 
a number assigned by fiscal intermediaries to identify providers on claims for services.
19
rejected claims
 
claims returned unpaid to the provider for clarification of any question and that must be corrected...
20
Universal claim form
 
the form developedby the Health Care Fnancing Administration (HCFA) (now know as the Centers...


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