Medical Billing Solutions
Common Medical Terms and their Definitions
- ABA Number
- The routing number to the provider's bank account.
- Assignment of Benefits
- Authorization granted by the patient/resposible party to allow the insurance company to pay benefits directly to the provider. The payment will be mailed to the provider rather than teh patient.
- Batch
- A group of claims to be printed or sent electronically to a clearinghouse.
- Beneficiary
- The person eligible to receive the benefits of a specific policy or program.
- Breach of Confidentiality
- Unauthorized release of confidential patient information to a third party
- Capiated Payments
- Payments made to providers who are staff members of HMO's and are paid a contractually agreed upon per capita fee for all services regardless of the actual number or nature.
- Capitation
- A reimbursement system used by HMO's and other managed care plans to pay the provider a fixed fee on a per capita basis that has no relationship to the type of services performed or the number of services.
- Clearinghouse
- An electronic data interchange service bureau which submits medical claims to the indicated payor.
- COBRA Insurance
- The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 gave employees who leave a company with employer sponsored group health insurance the right to continue their health insurance coverage for up to eighteen months, if they are willing to pay the entire cost of premiums. Medicare is primary to COBRA insurance.
- Health Maintenance Organization (HMO)
- A prepaid, managed care, health care provider group practice with responsibility for providing health care services for a fixed fee to subscribers in a given geographical area.
- Insurance
- Protection against risk, loss, or ruin by a contract in which an insurer or underwriter guarantees in return for the payment of a premium to pay a sum of money to the insured in the event of some contingency such as death, accident, or illness.
Home | Fees and Services | Benefits | Questions or comments
Common Medical Terms and their Definitions
- ABA Number
- The routing number to the provider's bank account.
- Assignment of Benefits
- Authorization granted by the patient/resposible party to allow the insurance company to pay benefits directly to the provider. The payment will be mailed to the provider rather than teh patient.
- Batch
- A group of claims to be printed or sent electronically to a clearinghouse.
- Beneficiary
- The person eligible to receive the benefits of a specific policy or program.
- Breach of Confidentiality
- Unauthorized release of confidential patient information to a third party
- Capiated Payments
- Payments made to providers who are staff members of HMO's and are paid a contractually agreed upon per capita fee for all services regardless of the actual number or nature.
- Capitation
- A reimbursement system used by HMO's and other managed care plans to pay the provider a fixed fee on a per capita basis that has no relationship to the type of services performed or the number of services.
- Clearinghouse
- An electronic data interchange service bureau which submits medical claims to the indicated payor.
- COBRA Insurance
- The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1986 gave employees who leave a company with employer sponsored group health insurance the right to continue their health insurance coverage for up to eighteen months, if they are willing to pay the entire cost of premiums. Medicare is primary to COBRA insurance.
- Health Maintenance Organization (HMO)
- A prepaid, managed care, health care provider group practice with responsibility for providing health care services for a fixed fee to subscribers in a given geographical area.
- Insurance
- Protection against risk, loss, or ruin by a contract in which an insurer or underwriter guarantees in return for the payment of a premium to pay a sum of money to the insured in the event of some contingency such as death, accident, or illness.