Who & Where
This anchor word is also known as a "Carrier Name," "Plan Name," or "Payor."
What is Insurance Name?
This is the total cost before discounts, often called "Charges Billed," "Submitted Charges," or "Fee Charged."
What is Billed Amount?
This specific fixed fee is sometimes called "TOS," "Office Visits," or "Patient Out of Pocket per visit."
What is Copay?
This code defines the procedure, often called "Procedure Codes," "Service Codes," or "Revenue Code CPT."
What is CPT Codes?
To track an electronic payment, RCM teams look for the "EFT Number," the "Trace Number," or the "Check/EFT Trace Number".
What is a Check Number?
You might see this on a report as "Subscriber Name," "Insured Name," or "Beneficiary Name."
What is Patient Name?
his is the actual check value, referred to as "Net Amount," "Plan Paid," or "Benefits Paid."
What is Paid Amount
This is the general term for what the patient owes, like "Member Balance," "Patient Liability," or "Subscriber Liability."
What is Patient Responsibility?
This unique claim identifier can be an "ICN Number," "Control Number," "DCN," or "CCN."
What is Claim Number?
This is money the provider cannot collect, labeled as "Write off," "Contract Write off," or "Ineligible Amount."
What is a Contractual Adjustment?
This unique identifier is often called a "Subscriber ID," "Member Identification #," or "Customer ID#."
What is Member ID?
This key term covers what the insurance agrees to pay, such as "Approved Amount," "Contract Amount," or "Eligible Expense."
What is Allowed Amount?
This percentage-based cost is known as "Cost Share," "Patient Coinsurance," or "PR2."
What is Coinsurance?
This identifies the specific payment document, called an "EFT Number," "Trace Number," or "Voucher #."
What is Check Number?
When a patient has not yet met their threshold, it is sometimes referred to as PR3 or Small Dollar Value.
What is copay?
In the system, this might appear as "PCN," "Patient Control #," or simply "Account #."
What is Patient Account Number?
This describes the specific "Check Amount" on a remittance, also known as "Issued Amount," "Net Paid," or "Reimbursement Amount."
What is Check Amount?
These extra charges for late payments are called "Penalty Fee," "Late Filing Charges," or "Interest Owed."
What is Interest?
This is the day the check was generated, listed as "RUN DATE," "Paid Date," or "Settlement Date."
What is Check Date?
In some billing systems, this is described as the Insurance Leftover or the Patient Obligation.
What is patient responsibility?
These are the specific days care was given, sometimes listed as "Procedure Dates," "Treatment Dates," or "From-Through dates
What is Date of Service?
This represents the quantity of services, labeled as "Billed Units," "Qty," or "Days Ct/Qty."
What is Units?
This phrase explains why a claim was paid a certain way, also called a "Denial Code" or "Remark Code."
What is Reason Code?
This is the "internal" number for a claim, often called a "Patient Control Number" or "Document number."
What is Claim Number?
This percentage-based cost share is identified by the code PR2 or Percent of Amount.
What is coinsurance?