Medical Insurance Claim Terminology

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Glossary of billing and insurance terms - Mayo Clinic

https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/glossary

DSGs are a system of classifying inpatient stays for payment. The Centers for Medicare & Medicaid Services uses DSGs to derive standard reimbursement rates for medical procedures and to pay hospitals for Medicare recipients. Some states use DSGs for all …

Common Health Insurance Terms and Definitions | WPS

https://www.wpshealth.com/resources/customer-resources/health-insurance-terminology.shtml

Allowable charge—sometimes known as the "allowed amount," "maximum allowable," and …

Glossary of Terms | Health Insurance, Medicare & More

https://www.anthem.com/glossary/

Health coverage may be called your health plan, health benefit plan, health coverage plan — these are all ways to describe a policy that helps you pay for your health care. Each …

A Guide to Health Insurance Terminology

https://www.goodrx.com/insurance/health-insurance/terminology-glossary

HMO. Stands for “health maintenance organization” and is a type of health insurance plan. …

Glossary of Medical Billing and Insurance Terms | UW …

https://www.uwmedicine.org/patient-resources/billing-and-insurance-2/glossary

CPT (Current Procedural Terminology) code A 5-digit numbering system that helps standardize professional and outpatient facility billing. There is a CPT code for certain …

Medical Billing Vocabulary & Key Terms

https://www.medicalbillingandcoding.org/billing-vocabulary-key-terms/

Medicare. A government insurance program, founded in 1965, that provides healthcare coverage for persons over 65 years old and for people with disabilties. Medicare …

Common Health Insurance Terminology 101 - JDRF

https://www.jdrf.org/t1d-resources/living-with-t1d/insurance/common-health-insurance-terms/

A claim is a request for payment that you or your doctor submit to your health insurance company when you receive care or services. The insurance company reviews the claim …

Glossary of Health Coverage and Medical Terms

https://www.cms.gov/CCIIO/Resources/Files/Downloads/dwnlds/uniform-glossary-final.pdf

your health insurance or plan has a “tiered” network and you must pay extra to see some providers. Your health insurance or plan may have preferred providers who are also …

Glossary of Common Medical Claims Termonology

https://clearinghouses.org/medical-claims-mgmt/

In introducing the topic of insurance claims, it’s necessary to state that there are university degrees offered in Revenue Cycle Management, which is the science of managing …

List of CPT/HCPCS Codes | CMS - Centers for Medicare …

https://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/List_of_Codes

List of CPT/HCPCS Codes. We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System …

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