EOB - Explanation of benefits
COB -Co-ordination of Benefits
MSP - Medicare as a Secondary Payer
POS - Place of service
TOS - Type of Service
DOS - Date of service
ICD - 9 -International Statistical Classification of Diseases and Related Health Problems
HCPCS - Healthcare Common Procedure Coding System
CPT - Current procedural Terminology
RBRVS - The Resource Based Relative Value Scale
RVU - Relating Value Unit
CHAMPUS - Civilian Health and Medical Program of the Uniformed Services
CHAMPVA - Civilian Health and Medical Program for the Veteran Administration
EIN - Employer Identification Number
ESRD - End-Stage Renal Disease
FICA - Federal Insurance Contributions Act
HICN - Health Insurance Claim Number
OBRA - The Omnibus Budget Reconciliation Act
CF - conversion factor
EGHP - Employer Group Health Plan
QMB - Qualified Medicare Beneficiaries
UCR - Usual, customary and reasonable
PCP - primary care physician
HMO - Health Maintenance Organization
PPO - Preferred Provider Organization
TPA - Third Party Administrators
Medical billing definitions - Insurance
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Medical Billing Popular Articles
Allergic rhinitis due to pollen J30.1 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement pu...
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DESCRIPTION Allergy testing, evaluations, and immunotherapy are eligible for coverage according to the schedule of covered services in pla...
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Its often confused that BCBS have lot of prefixes and where to contact. However we have some guide to follow, using prefixes we could find t...
a. General Requirements When Medicare is the secondary payer, the claim must first be submitted to the primary insurer. The primary insure...
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Denial code co - 45 - Charges exceed your contracted/legislated fee arrangement. Note: This adjustment amount cannot equal the total servic...
Generally speaking, when we say 'objective measures,' what does that mean? Answer: Objective measures consist of standardized p...