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MBCS

claims adjustment reason codes (CARC)

are used to communicafe why a claim of service line was denied or paid didferently than if was billed

what is required on all claims to be processed?

DOB

what reviews the documentation to determain wheather approprite billing practices were followed and accurate reimbursment was received?

audit

what is a third party payer?

is an insurance company that offers plans that pay health

HCPCS

are codes are used in physicians clinic

what is a modifier ?

indicates laterality of the procedure

what is a beneficary notice?

is a form that is required for medicare recepients it allows the patient to make an informed decision about an item or service that might not be covered by medicare

what is redetermination ?

is the first step in the appeals process

CPT codes

are used to code provider and out patient services

health care cleaning house

are covered entitles affected by HIPAA security rules. They are the middle man between the provider and the third party payer.

what is required on the claim forms?

NPI

aging report

is used for systematically arranging a practices accounts receivable based on date of service. within 45 days

any payment that cannot be recovered by the office of s collection agency is ?

a bad debt

what is cordination of benefits

precents multiple 3rd party payers from paying benefits covered by other policies

what is an allograft

is a tissue transplanted from one person to another

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