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What are all these CODES?
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Processing in the DIAMOND
123?, 456?, 789?
It's all about the CLAIM
100
This type of code describes a patient's condition or illness (please provide the industry term for this type of code)
What is an ICD
100
These checks will screen claims for missing information and prevent it from printing
What is a Claim Rejection
100
This step in the billing process queues claims
What is Post?
100
This is the electronic version of the EOB.
What is an 835 ERA?
100
Paper claims are sometimes referred to as this.
What is a Print Image Download (PID)?
200
This type of code is used to document any durable medical equipment (DME) used in patient care.
What is a HCPC?
200
These checks are used to typically screen an account for missing ABS information
What is a Proration Hold?
200
This step in the billing cycle determines what type of bill a patient will receive
What is Cutoff?
200
The clearinghouse will send this to a hospital after receiving a claim file
What is a 277CA Claim Acknowledgement?
200
This type of claim reports the standard or institutional charges on an account
What is a UB04?
300
In the MEDITECH PA system, CPT and HCPC codes are defined as this in the Charge Description Master.
What is an Alternate Code?
300
If an account fails this type of check it will prevent a bill from cutting.
What is a UR Check?
300
This type of bill is produced on a monthly basis
What is an Interim Bill?
300
A clearinghouse would be used to convert a PID into this.
What is an 837?
300
This number replaces the account number in field 3a on a UB04 claim.
What is the Claim Submitter Identifier (CSID)?
400
This type of code is assigned a reimbursement rate which allows the hospital to forecast the amount to be reimbursed for outpatients.
What is an APC code?
400
This worklist allows users (billers) to review any failed account checks.
What is a the Account Check Worklist?
400
This is written off as a result of an insurance contract
What is a Contractual Adjustment?
400
This is used by a hospital or provider to request the status of a submitted claim from an insurance? and this would be sent back as a response.
What is a 276 Claim Status Request and a 277 Claim Status Response?
400
Information such as the patient’s admit priority, admit source, discharge disposition and subscriber relationship all appear on a claim as this?
What is a Claim Code?
500
This type of code help to groups charges on a claim by department. This code is also referred to as this in the MEDITECH PA system.
What is a Revenue Code? and What is a Subcategory?
500
These checks are performed by the clearinghouse to "scrub" a submitted claim and ensure all necessary financial information is documented.
What are NCCI Edits?
500
This is the status an account will be placed in should it fail a proration hold.
What is UR?
500
This would be sent to a hospital and would include a CARC code.
What is an 835 ERA?
500
This field on a UB04 claim will report different information when the patient is an inpatient vs an outpatient.
What is field 44 (HCPC/RATES)?