Revenue Abbreviations
CDM stands for
What is Charge description master?
131
What is an original outpatient claim?
The amount of cost, usually annually, the policyholder must incur before the plan will assume liability for the remaining covered expenses
What is Deductible?
NDC stands for
What is national drug code?
Charges exceed your contracted/legislated fee arrangements
What is denial code 45?
COB stands for
What is coordination of benefits?
117
What is an inpatient corrected claim?
A pre-established percentage of eligible expenses after the deductible is paid
What is coinsurance?
Hospital claim form
What is a UB04?
The procedure code is inconsistent with the modifier used.
What is denial code 04?
FFS stands for
What is fee for service?
115
What is an inpatient late charge only claim?
A three digit code linked to every charge
What is a revenue code?
Hospital bill that lists all services received
What is an itemized bill?
These are non-covered services because this is not deemed a "medical necessity" by the payer
What is denial code 50?
PFS stands for
What is patient financial system and/or patient financial services?
118
What is an inpatient voided claim?
A list of services and the amount that the healthcare insurance plan will pay for healthcare claims
What is a fee schedule?
Hospital bills that have completed service but have not been billed to insurance yet
What is Discharged Not Final Bill(DNFB)?
Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor
What is denial code 109?
RCM stands for
What is revenue cycle management?
134
What is an outpatient Interim - Last Claim ?
A form that details how the payer processes the claim for payment sent to the patient
What is an EOB?
Department responsible for reviewing diagnosis codes
Who is coding department?
The attachment/other documentation that was received was incomplete or deficient.
What is denial code 251/252?