To be a successful medical biller and coder it is very important to be familiar with the medical billing terms used in this profession. After going through this blog you will have the list of all the most important terms that fall towards the end.so here are the medical billing and coding terms:
Allowed Amount: The maximum amount a plan will pay for a covered health care service. The patient typically pays the remaining balance if there is any amount left over after the allowed amount has been paid. This amount should not to be confused with co-pay or deductibles owed by a patient. This amount is called co-insurance.
AR Aging: A periodic report that categorizes a company’s accounts receivable according to the length of time an invoice has been outstanding and in medical billing term it refers to insurance claims that haven’t been paid or balances owed by patients overdue by more than 30 days. Aging claims may become denied if they aren’t filed in time with a health insurance company.
Applied to Deductible (ATD): This is an amount of money , a patient need to spend before insurance coverage begins and he ows this amount to a provider. A patient’s deductible is determined by their insurance plan and can range in price.
Assignment of Benefits (AOB): AOB is a medical billing term means that a document is signed by a policyholder that allows a third party, such as a patient requests that their health benefit payment be made directly to a designated person or facility such as a physician or hospital. Assignment of benefits occurs after a claim has been successfully processed with an insurance company.
Advance Beneficiary Notice (ABN) A notice that a doctor or supplier should give a Medicare beneficiary when furnishing an item or service for which Medicare is expected to deny payment.If ABN is not signed by the beneficiary then in case of denial this will be a loss for doctor or supplier.
Authorization: This is an approval by an insurance company, before receiving certain healthcare services A patient may be denied coverage if they see a provider for a service that needed authorization without first consulting the insurance company
Appeal: The medical billing term is a process occurs when a patient or a provider attempts to convince an insurance company to pay for healthcare after it has decided not to cover costs for someone on a claim.
Ancillary Services: Any service administered in a hospital or other healthcare facility other than room and board, including bio metrics tests, physical therapy, and physician consultations among other services.
Application Service Provider (ASP): ASP is a digital network that facilitates healthcare providers to access quality medical billing technology and software and without need to purchase and maintain it themselves but they typically pay a monthly fee to the company that maintains the billing software.