A private company that serves to transmit and translate claim information from a health care provider or other billing entity to the third-party payers in the format required by the payer.

A written bill for services, submitted by a patient or on behalf of a patient to the patient’s health insurance carrier for payment, per the terms of the patient’s health insurance plan.

Preparation, submission, and collection of health care claims.

A comprehensive list of all services or supplies offered at a clinic or hospital including the procedure code and price.

Also referred to as “private” insurance, a form of health insurance that is paid for by somebody other than the government.  It may be paid for by the policy-holder and/or by the policyholder’s employer.

The process of developing an agreement between a health care provider and a third-party payer that allows the provider recognized as an in-network provider.

The portion of the total amount billed for services that the patient is responsible for paying as determined by the terms of the patient’s health insurance policy.

The process of establishing the qualifications of a health care provider with the health insurance provider.

Computer-based systems for managing medical and/or billing information for patients.

Also referred to as a “superbill,” this form is particular to each clinic and is designed to capture the diagnostic and procedural codes most frequently used in that clinic.