Insurance
Copayment
Combination Code
When healthcare services that are usually separate are considered as a single entity for purposes of classification and payment.
Bundled Code
The process of teaching the patient a new skill by having the patient observe and imitate it.
Modeling
The scheduling of similar appointments together at a certain time of the day or week.
Cluster Scheduling
A fixed dollar amount that must be paid by the insured before additional expenses are covered by insurer
Deductible
The way a diagnosis is communicated to the third-party payer on healthcare claim form
Diagnosis Code
A book with the most commonly used system of procedure codes. It is the HIPAA-required code set for physicians’ procedures.
Current Procedural Terminology
Method of teaching that includes demonstrations of techniques that may be necessary to show that something has been learned.
Participatory Teaching
The basic format of an appointment book, established by blocking off times on the schedule during which the doctor is able to see patients. Also, the material between the cells of connective tissue.
Matrix
A list of the costs of common services and procedures performed by a physician
Fee Schedule
The science and study of causes of disease and their mode of operation
Etiology
The insurance carrier bases reimbursement on a code level lower than the one submitted by the provider.
Downcoding
Performing a diagnostic test on a person who is typically free of symptoms.
Screening
A system of scheduling where patients arrive at regular, specified intervals, ensuring the practice a steady stream of patients throughout the day.
Time Specified Scheduling
A medical procedure that is not required to sustain life but is requested for payment to the third-party payer by patient or physician.
Elective Procedure
Code set that is based on a system maintained by the WHO
International Classification of Diseases
A fatal outcome.
Method of teaching that provides a patient with a description of the physical sensations he or she may have as part of the learning or the procedure involved.
Sensory Teaching
A system of scheduling in which the number of patients seen each hour is determined by dividing the hour by the length of the average visit and then giving that number of patients appointments with the doctor
Wave Scheduling
A fixed percentage of covered charges paid by the insure person after a deductible has been met
Coinsurance
In ICD-10, the side of the body affected by diagnosis
Laterality
Code that represents a medical procedure, such as surgery and diagnostic tests, and medical services, such as an examination to evaluate a patient’s condition.
Procedure Code
Participatory teaching method in which the technique is first described to the patient and then demonstrated to the patient; the patient is then asked to repeat the demonstration.
Return Demonstration
Leaving large, unused gaps in the doctor’s schedule; this approach does not make the best use of the doctor’s time.
Underbooking