Date the insurance contract expired or the date a subscriber or dependent ceases to be eligible.

Group Health Plan. A means for one or more employer who provide health benefits or medical care for their employees (or former employees).

When a second CPT procedure is performed during the same physician visit as the primary procedure.

Electronic Medical Records. Also referred to as EHR (Electronic Health Records). This is a medical record in digital format of a patients hospital or provider treatment. An EMR is the patient's m [..]

Specialty standard codes used to indicate a providers specialty sometimes required to process a claim.

Claim for insurance coverage paid in addition to primary and secondary insurance. Tertiary insurance covers gaps in coverage the primary and secondary insurance may not cover.

Claim form for hospitals, clinics, or any provider billing for facility fees similar to CMS 1500. Replaces the UB92 form.

weight: normal;"> - Version 5010 of the X12 HIPAA transaction and code set standards for electronic healthcare transactions. This standard includes transactions for claims, referrals, claim st [..]

weight: normal;">- Affordable Care Act. Also referred to as "ObamaCare". A Federal law enacted in 2010 intended to increase healthcare coverage and make it more affordable. It also e [..]

The reimbursement amount an insurance company will pay for a healthcare procedure. This amount varies depending on the patients insurance plan. For 80/20 insurance, the provider accepts 80% of the all [..]