HIPAA
Insurance Commissioner
Poly-
HMO
TRICARE
100
Request for review of an insuance claim that has been underpaid.
What is Appeal?
100
Department of Appeal Board
What is DAB?
100
Paper of electronic insurance claim where payment has been rejected.
What is denied claims?
100
Federal Trade Commission
What is FTC?
100
Health Maintenance Organization
What is HMO?
200
Known as a follow up or tracer, request made for status of a claim
What is Inquiry?
200
Supplemental insurance policy for Medicare beneficiary, covers deductible and copayments.
What is Medigap?
200
Money paid over and above the amoutn the amount due by the insurance or patient.
What is overpayment?
200
a claim that is discarded by the insurance company because of a technical error.
What is Rejected claim?
200
To assess how much payment should be made.
What is review?
300
Administrative Law Judge
What is ALJ?
300
Center for Medicare and Medicaid Services?
What is CMS?
300
Insurance claim submitted to an insurance company and payment is overdue.
What is Delinquent claim?
300
Explanation of benefits.
What is EOB?
300
Healthcare Common Procedure Coding system
What is HCPCS?
400
Hearing officer
What is HO?
400
Insurance claim that cannot be found
What is Lost claim?
400
National Provider Identification
What is NPI?
400
Send another request for payment for an overdue bill
What is Rebill?
400
Document details service billed and describes payment determination.
What is RA?
500
Claim that is held in a pended state because of an error or need for more information.
What is suspended claim?
500
Used to track pending or resubmitted claims
What is tickler file?
500
Employee retirement Income Security Act
What is ERISA?
500
Health Information Portability and Accountability Act
What is HIPAA?
500
Review of patients case by one or more physicians to evaluate another physician
What is peer review?
M
e
n
u