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