FACESHEET
DOB
DATE OF BIRTH
POS
PLACE OF SERVICE
Insurance coverage for low income patients. Funded by Federal and state government and administered by states.
MEDICAID
Requirement of insurance plan for primary care doctor to notify the patient insurance carrier of certain medical procedures
PREAUTHORIZATION
DOS
DATE OF SERVICE
A unique 10 digit identification number required by HIPAA and assigned through the National Plan
NPI
Physicians visits and outpatient procedures
Medicare Part B
software used for the daily operations of a providers office. Typically used for appointment scheduling and billing.
Practice Management Software
A responsible party and/or insured party who is not a patient
GUARANTOR
CPT treatment code that provide additional information to insurance payers for procedures or services that have been altered or “modified” in some way, they do not affect the code of the procedure that was changed
MODIFIER
Medicare insurance for prescription drug costs for anyone enrolled in Medicare Part A or B.
Medicare Part D
One of the medical billing terms for the form the provider uses to document the treatment and diagnosis for a patient visit
Superbill
A unique number assigned by the provider or health care facility to identify the patient medical record
MEDICAL RECORD NUMBER
The condition responsible for the majority of the resources provided to a patient while receiving care.
PRIMARY DIAGNOSIS
Insurance provided by federal government for people over 65 or people under 65 with certain restrictions for hospital coverage.
Medicare Part A
Also known as Employer Identification Number (EIN).
TIN
The person responsible for paying a patients medical bill. Also referred to as the guarantor.
RESPONSIBLE PARTY
Specialty standard codes used to indicate a providers specialty sometimes required to process a claim.
TAXONOMY CODES
Commercial insurance plan where the patient can use any doctor or hospital within the network.
PPO
Physician who specializes in a specific area of medicine, such as urology, cardiology, orthopedics, oncology, etc. S
SPECIALIST