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medicalbillingandcodingonline.com
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Definitions (153)
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term date
The end date for an insurance policy contract, or the date after which a person no longer receives or is no longer eligible for health insurance with company. Term dates are typically determined on a case-by-case basis. Source: medicalbillingandcodingonline.com (offline)
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secondary procedure
This is when provider performs another procedure on a patient covered by a CPT code after first performing a different CPT procedure on them. Source: medicalbillingandcodingonline.com (offline)
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secondary insurance claim
The claim filed with the secondary insurance company after the primary insurance company pays for their portion of healthcare costs. Source: medicalbillingandcodingonline.com (offline)
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taxonomy code
Medical billing specialists utilize this unique codeset for identifying a healthcare provider’s specialty field. Source: medicalbillingandcodingonline.com (offline)
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tertiary insurance claim
A claim filed by a provider after they have filed claims for primary and secondary health insurance coverage on behalf of a patient. Tertiary insurance claims often cover the remaining healthcare costs such as deductibles and co-pays left over after the primary and secondary claims have been processed. Source: medicalbillingandcodingonline.com (offline)
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ub04
A form used by providers for filing claims with insurance companies. The UB04 form has a format similar to that of the CMS 1500 form. Source: medicalbillingandcodingonline.com (offline)
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allowed amount
The sum an insurance company will reimburse to cover a healthcare service or procedure. The patient typically pays the remaining balance if there is any amount left over after the allowed amount has been paid. This amount should not to be confused with co-pay or deductibles owed by a patient. Source: medicalbillingandcodingonline.com (offline)
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american medical association
The AMA is the largest organization of physicians in the U.S. dedicated to improving the quality of healthcare administered by providers across the country. The current procedural technology (CPT) code set is maintained and revised by the AMA in accordance with federal guidelines. Source: medicalbillingandcodingonline.com (offline)
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aging
A formal medical billing term that refers to insurance claims that haven’t been paid or balances owed by patients overdue by more than 30 days. Aging claims may become denied if they aren’t filed in time with a health insurance company. Source: medicalbillingandcodingonline.com (offline)
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ancillary services
Any service administered in a hospital or other healthcare facility other than room and board, including biometrics tests, physical therapy, and physician consultations among other services. Source: medicalbillingandcodingonline.com (offline)
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