What is Assignment of Benefits (AOB)?
A written consent, signed by the policyholder/patient (in the absence of the policyholder) at the time of registration. This is
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AR Terminologies
What is Appeal?
A process by which patients or doctors/hospitals can object when they disagree with the health plan’s decision not to pay
Read MoreWhat is Aging Report?
An aging report in medical billing terms means it is an insurance claim or patient’s balances that are unpaid for
Read MoreWhat is CLIA number- (Clinical Laboratory Improvement Amendments)?
CLIA was Passed by Congress in 1988 to ensure the accuracy, reliability, and timeliness of patient test results, wherever a
Read MoreWhat is Clean Claim?
A claim is one that will pass through all front-end edits to the insurance processing units through an electronic clearing
Read MoreWhat is Capitation?
It is like a pre-paid cheque that was paid to the provider periodically. Insurance will assign patients, and capitated providers
Read MoreWhat is Billing Address?
Insurance company EOBs and Cheques were received at this address. It will be in CMS 1500 Box# 33. The billing
Read MoreWhat is the Billed amount of the claim/Charge amount of the claim?
It is the provider’s charge for the services he did. Billed amounts vary from provider to provider.
Read MoreWho is Beneficiary (OR) Insured Person?
A person who is eligible for receiving benefits under the insurance policy. He is also called an enrolee or insured
Read MoreWhat is Authorization Number?
Before providing certain services the provider must receive approval from a staff member of the payer’s UMR dept (Utilization Management
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