Customer Service Call Vocabulary

Vocabulary flashcards based on a customer service call transcript.

Appeal

The process of reconsidering a claim decision.

Appeal ID

A unique identifier for tracking the appeal process.

Authorization

Approval required before certain medical services can be performed.

Claim

A request for payment for medical services or procedures.

Claim Number

A unique code assigned to a specific claim for tracking purposes.

Allowed Amount

The amount that the insurance company has determined to be the standard cost for a particular service.

Paid Amount

The portion of the allowed amount that the insurance company has covered.

Check

The document sent to the payee that shows the amount that was paid.

Call Reference Number

A series of numbers and letters used to identify a specific phone call.

ER

Emergency room.

Overturned

To reverse or invalidate a prior decision.

Reprocessed

To process a claim again, potentially with corrections or additional information.