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Medical Billing Vocab & Key Terms

Across
Automatic process of applying prices to a claim
A % of cost that is paid after the deductible has been met.
A form used to submit claims to Medicare & Medicaid
contracted by the federal government to administer a program and process its payments
This only occurs after a claim has either been denied or rejected
A document attached to a processed claim
amount of money you pay before the insurer starts covering the cost of medical expenses
Down
Digital version of the EOB
Medicare places a yearly limit on certain medical services
Claim form used by the hospital
An organization that will review. edit & format claims before sent to the insurance.
An arrangement between a provider & insurance payer, typically occur within HMOs
Formally known as CHAMPUS
Privacy Act
States Health Plan