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Definitions (137)
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Term Date
Date the insurance contract expired or the date a subscriber or dependent ceases to be eligible.
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GPH
Group Health Plan. A means for one or more employer who provide health benefits or medical care for their employees (or former employees).
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Secondary Procedure
When a second CPT procedure is performed during the same physician visit as the primary procedure.
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EMR
Electronic Medical Records. Also referred to as EHR (Electronic Health Records). This is a medical record in digital format of a patients hospital or provider treatment. An EMR is the patient's m [..]
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Taxonomy Code
Specialty standard codes used to indicate a providers specialty sometimes required to process a claim.
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Tertiary Insurance Claim
Claim for insurance coverage paid in addition to primary and secondary insurance. Tertiary insurance covers gaps in coverage the primary and secondary insurance may not cover.
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UB04
Claim form for hospitals, clinics, or any provider billing for facility fees similar to CMS 1500. Replaces the UB92 form.
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5010
weight: normal;"> - Version 5010 of the X12 HIPAA transaction and code set standards for electronic healthcare transactions. This standard includes transactions for claims, referrals, claim st [..]
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ACA
weight: normal;">- Affordable Care Act. Also referred to as "ObamaCare". A Federal law enacted in 2010 intended to increase healthcare coverage and make it more affordable. It also e [..]
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Allowed amount
The reimbursement amount an insurance company will pay for a healthcare procedure. This amount varies depending on the patients insurance plan. For 80/20 insurance, the provider accepts 80% of the all [..]
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