Billing & Coding Week 3 Medical Terms
the amount charged by the practice when providing services.
the amount the insured has to pay toward the amount allowed by the insurance company for services.
explanation of benefits.
resource-based relative value scale.
usual customary and reasonable.
extremities, top, extreme point
sharp, severe, sudden
amnion (sac surrounding the embryo)
colon (large intestine)
urinary bladder, cyst
larynx (voice box)
spinal cord, bone marrow
neither, natural, neutrophil
-ac, -al, -ary
-eal, -ic, -ical
resembling, derived from
full of, pertaining to sugar
surgical puncture to remove fluid
process of recording
breakdown, seperation, destruction
condition, usually abnormal
development, formation, growth
falling, drooping, prolapse
instrument for visual examination
stopping, controlling, placing
a form of prepayment in which a provider agrees to furnish services to members of a particular insurance program for a fixed fee.
coordination of benefits.
current procedural terminology.
the dollar amount that must be paid by the patient before insurance will pay a claim based on coverage plans and benefits.
diagnosis related group.
healthcare common procedure coding system.
international classidication of diseases, 9th edition, clinical modification.
the ranking fees from all providers in a given area to develop a reimbursement base.
place of service codes.
a method for preapproving all elective admissions, surgeries, and other services as required by insurance carriers.
professional review organization.
relative value scale.
third party payer
a carrier that has an agreement with an individual or organization to provide heath care benefits.
another name for an insurance company that covers health care services.
coordination of benefits.
health maintenance organization.
preferred provider organization. A special insurance program offering patients higher reimbursement by using physicians, hospitals, and laboratories within the PPO network.
one who supplies health care services.
a physician in a specialty area other than primary care who provides specialized care to the patient.
civilian health and medical program of the uniformed services.
workers' compensation a contract that insures a person against on the job injuries paid for by the employer.
a method of settling a dispute with the judicial process involving an impartial third party to render a decision for settlement of a claim.
the process of taking a witness's sworn testimony by an attorney outside of the courtroom setting.
a compensable injury to an employee hired in one state but is injured on the job outside of that state.
independent medical examiner.