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Medical Manager Terms Unit 2

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Assignment of Benefits
Permission granted by the insured that allows the insurance company to send the amount paid directly to the physician, health care provider, hospital, or nursing facility. .
Auto-populate
Pressing the ENTER key in the Medical Manger will automatically fill in many data fields; this is known as:
Consent
permission from a patient, either expressed or implied, for something to be done by another
default response
the information that appears automatically when ENTER is pressed
Demographics
A patients name, age, address, Social Security number, and employer information are generally referred to as:
Dependents
Persons covered under the insured's contract. This usually includes a spouse and/or unmarried children.
Extended Information
Additional information regarding the patient's work, school, or volunteer work is called
Group Name
this is a field on the Ins policy screen that allows you to specify who the group policy belongs to
Group Number
In reference to Health insurance - A number assigned to a group for billing purposes.
Guarantor
Indiviual who promises to pay the bill. Policyholder
Guarantor's Full Report
A report that provides patient personal information, extended information. and insurance information from the guarantor's file.
Identification (Insurance) Number
An ID # assigned by the insurance company to identify a particular policy.
Insurance Coverage Priority
This is information set in the Insurance Coverage Priority screen in the system that establishes the insurance policy or policies a patient is covered by. This determines which plan is to be billed first for the patient's charges and, if applicable, which plan is to be billed for the remaining charges.
Insurance Policy Information
All the information regarding an insured person's policy: The name and location of the insurance company to which claims are to be sent for each patient.
Insurance Type
The term referring to the category of insurance carried by the patient. ex: private, group, worker's compensation etc.
Insured
person covered by the policy of insurance who may or may not be the applicant or policy owner
Insured Party
The person whose name the insurance coverage is held under; may be known as subscriber
IPR
Insured Party Record - An individual record maintained inside the Insured Party File.
New Guarantor's Full Report
A comprehensive report run to verify the accuracy and completeness of data entry for new guarantors.
New Insured Party
One of the three choices to select at the bottom of the Insurance Policy Information screen used to identify the person who owns the insurance policy.
Patient enrollment form
patient registration form: the form a patient completes when he first sets up his account at the medical practice. Typically contains the patients demographics, insurance plan information etc for himself and each of his dependents.
Patient's Account Number
the unique number assigned to every patient at the time he is entered into the system during New Patient Entry. It may never be changed.
Policyholder
This is the individual who owns the insurance policy.
Primary Insurance
The health plan that pays benefits first when a patient is covered by more than one plan.
PHI
Protected Health Information - any information that identifies an individual and describes his health status, age, sex, ethnicity, or other demographic information
Referring doctor
A physician who refers his or her patient to another physician.
Responsible Party
person or entity other than the insured or the patient who will pay a patient's charges
Secondary Insurance
the health plan that pays benefits after the primary plan when a patient is covered by more than one plan
Signature Date
the date on which the document was signed
Subscriber
the name of the person in which the insurance policy is issued to (SAME AS POLICY HOLDER)
Suffix Number
indicates patient sequence in the account