lady 2
| Definition |
|---|---|
Authorization | Formal approval from an insurer for a service or medication |
Beneficiary | Person covered under a health insurance plan |
Co-payment | Fixed fee paid by a patient at the time of service |
Deductible | Amount paid out-of-pocket before insurance coverage begins |
EOB (Explanation of Benefits) | Statement detailing what the insurer paid, denied, or adjusted |
ICD-10 | Diagnostic coding system for medical conditions |
CPT Code | Procedure codes used for billing medical services |
HCPCS | Medicare billing codes for supplies and services |
HIPAA | Law protecting patient data privacy and security |
EMR | Electronic record of a patient’s health data within a single practice |
EHR | Shared electronic health record across multiple providers |
Clearinghouse | Entity that transmits medical claims between providers and payers |
CMS-1500 | Standard claim form for outpatient services |
UB-04 | Claim form used for inpatient hospital billing |
Referral | Sending a patient to another provider for specialized care |
Audit | Inspection or review of records and procedures |
Matrix | Format used to establish a time schedule for appointments |
Encounter Form | Document listing procedures performed and their billing codes |
SOAP | Charting method: Subjective, Objective, Assessment, Plan |
Dictation | Verbal recording of clinical notes for transcription |
Subjective | Information provided by the patient, not measurable |
Objective | Observable and measurable clinical findings |
Progress Note | Record of ongoing treatment and patient progress |
Privacy Officer | Person responsible for managing protected health information |
Promoting Interoperability | CMS program for improving health data exchange and access |
Indexing | Cross-referencing system for organizing office files |
Continuity of Care | Uninterrupted delivery of healthcare services |
Encoder | Software for searching medical billing codes |
Chronologic | Arranged in order of time or occurrence |
CHEDDAR | Charting method: Chief Complaint, History, Examination, Details, Drugs, Assessment, Return visit |
HL7 Protocols | Standards for exchanging health information between applications |
Chief Complaint (C/C) | Main reason for the patient’s visit |
Transcription | Conversion of dictated notes into written format |
Utilization | The act of using resources effectively |
Flex Time | Flexible scheduling of work hours |
Tickler File | Chronologic file used for follow-up reminders |
HPIP | Charting method: History, Physical, Impression, Plan |