Revenue Abbreviations
RCM stands for
What is Revenue Cycle Management?
RA stands for
What is Remittance Advice?
The amount 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?
Non-covered services per policy
What is code 96?
FFS stands for
What is fee for service?
PPO stands for
What is Preferred Provider Organization?
A pre-established percentage of eligible expenses after the deductible is paid
What is coinsurance?
Hospital Claim Form
What is a UB04?
Non-Covered Services due to Medical Necessity
What is code 50?
COB stands for
What is Coordination Of Benefits?
HMO stands for
What is Health Maintenance Organization?
A three digit code linked to every charge
What is a revenue code?
Professional fee claim Form
What is 1500 claim form?
Precertification/Authorization/Notification Absent
What is code 197?
ABN stands for
What is Advance Beneficiary Notification?
CMS stands for
What is Centers for Medicare and Medicaid Services?
A list of services and the amount that the healthcare plan will pay for claims
What is a fee schedule?
Next Step when patient contact has been exhausted
What is move charges to self-pay?
Charges exceed the contracted fee arrangements
What is code 45?
CDM stands for
What is Charge Description Master?
What is Managed Care Organization?
A form detailing how the payer processes the claim for payment sent to the patient
What is an EOB?
Intermediary between healthcare providers and insurance companies, electronically processing and submitting medical claims
What is a clearinghouse?
Claim/service lacks information or has submission/billing error(s)
What is code 16?