What is Billing Address?
Insurance company EOBs and Cheques were received at this address. It will be in CMS 1500 Box# 33. The billing
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What 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
Read MoreWhat is Allowed amount/considered amount/Approved amount?
The dollar amount an insurance company deems fair for a specific service or procedure. This is the maximum amount that
Read MoreWhat is an Advance Beneficiary Notice (ABN)?
A notice that the hospital or doctor gives the patient before the treatment, telling the patient that Medicare will not
Read MoreWhat is Account Number/Encounter #?
What is Account Number/Encounter#? The number is given by the doctor or hospital for each and every patient’s medical visit
Read MoreWhat is Ambulatory Surgery (ASC)?
Outpatient surgery or surgery that does not require an overnight hospital stay (more than 24 hours). Other names Day surgery
Read MoreMOCK-CALL_DEDUCTIBLE
Sandy: Thanks for calling this is Sandy how may I help you today? James: Hai my name is James I
Read MoreMaximum Benefit Exhausted/Met Denial.
Meaning: Some insurance companies limit the dollar amount they will pay per year for certain services or they limit the
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