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common terms
UT Southwestern Medical Center wants to make sure our patients understand the billing and insurance aspects of their visit. The glossary below explains some of the more common billing and insurance te [..]
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advance beneficiary notice
A form signed by patients that lets them know that certain tests or services planned by the doctor may not be covered by Medicare. The ABN also informs patients they may be responsible for paying thes [..]
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approved amount
The payment a participating provider agrees to accept for a service. The approved amount is decided by insurance company fee schedules, Current Procedural Terminology (CPT®) coding standards, and gene [..]
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assignment of benefits
This term means that the facility or the physician agrees to accept payment from an insurance company first and bill the patient for any after-insurance amounts due. Patients "assign" the ri [..]
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benefit
The term "benefit" is used for the medical services that are paid for under a patient's insurance plan.
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birthday rule
Used to decide the primary and secondary insurance coverage for dependent children's medical charges. The word "birthday" refers only to the month and day in a calendar year, not the ye [..]
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claim
Refers to the form submitted to the insurance company for payment of benefits.
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