Charting
Information that includes follow-up appointments, provider orders, instructions, educational resources, and financial account information
AVS (after visit summary)
The designed time frame for appointments based on the method of appointment durations.
matrix
Form that tracks the amount of inventory the office has and can be used to predict anticipated amounts needed based on the history.
inventory supply log
The amount that must be paid before benefits are paid by the insurance company.
Deductible
A report that lists outstanding balances that have not been paid by either the patient or the insurance payer.
aging report
The use of electronic information and telecommunication technologies to
support long-distance clinical healthcare, patient and professional health
education, and public health and health administration
Telehealth
Scheduling patients in groups with common medical needs.
clustering
Document that identifies how the provider will distribute and disclose a patient’s protected health information.
Notice of Privacy practices (NPP)
The percentage of the allowed amount the patient will pay once the deductible is met.
coinsurance
An organization that accepts the claims data from a health care provider, performs edits comparable to payer edits, and submits clean claims to the third-party payer.
clearinghouse
Healthcare Common Procedure Coding System codes that identify supplies and procedures not described by CPT codes
HCPCS codes
A type of scheduling in which two or more patients are scheduled within the same time slot.
Double-booking
Software used to electronically manage administrative functions, such as scheduling appointments, integrating patient documentation from electronic health records, coding, billing, and revenue cycle tasks such as running aging reports and managing the accounts receivable.
practice management system (PMS)
A set amount determined by the plan/payer that the patient pays for specified services, usually office visits and emergency department visits
copayment
Meeting the stipulated requirements to participate in the health care plan.
elegibility
Current Procedural Terminology codes that identify medical services and procedures performed by a provider.
CPT codes
Scheduling two or three patients during a designated hourly time period (last 30 min of the hour, patients seen in order of arrival).
Wave Scheduling
The process of reviewing a patient's medical record (chart) for
completeness, accuracy, compliance, and to ensure documentation
supports the services billed
Chart review
A federal agency that oversees the Medicare program and assists states with Medicaid programs.
CMS (centers for Medicare and Medicaid services)
A tool that allows for a submission of the coded visit to the insurance company by participating providers for reimbursement decisions by third-party payers while the patient is present.
real time adjudication (RTA)
International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) codes based on the provider’s diagnosis (why the patient is in need of medical services).
diagnosis codes
Patient who received same-provider services within the last 3 years.
established patient
The entire process of managing claims processing, payment, and revenue generation.
revenue cycle
Approval of insurance coverage and necessity of services prior to the patient receiving them.
preauthorization
A record of the diagnosis and procedures covered during the current visit; also known as superbill.
encounter form