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
Procedure code and Description 99251 Inpatient consultation for a new or established patient, which requires these 3 key components: A pro...
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Hyperlipidemia Hyperlipidemia (hyperlipemia) involves abnormally elevated levels of any or all lipids and/or lipoproteins in the blood. Hy...
HCPCS Codes Effective for claims with dates of service on June 30, 2011, Medicare providers shall report one of the following HCPCS codes...
Generally speaking, when we say 'objective measures,' what does that mean? Answer: Objective measures consist of standardized p...
Q: My patient enrolled in a Medicare Advantage (MA) plan during the middle of the inpatient hospital stay. Who should I bill? A: When a p...
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...
1 Deductible Amount 2 Coinsurance Amount 3 Co-payment Amount 4 The procedure code is inconsistent with the modifier used or a required mo...
Denial code co - 45 - Charges exceed your contracted/legislated fee arrangement. Note: This adjustment amount cannot equal the total servic...
1) Aetna: 120 days . 90 Days 2) Amerigroup: 180 days. 3) Bcbs: 1yr . 180 days updated. 4) Cigna: 180 days. 5) Humana: 15 mon...