CRCR Glossary Terms Questions with Complete Solutions Rated A+

AAR - After-hours activity report ABN - Advance Beneficiary Notice ACC - Ambulatory care center Access - Ability to receive hospital; physician or other medical services without regard to an individual's ability to pay Accounts receivable (A/R) - Money owed to an organization for goods or services furnished Accounts receivable (A/R) collection period - Number of days in the accounting period divided by accounts receivable turnover. This ratio tells you the average time it takes to collect amounts due. Accounts receivable (A/R) turnover - Services rendered on credit during the period divided by the A/R balance. This ratio tells you how many times you collect your AR in a given cycle. Accreditation - Formal process by which an agency or organization evaluates and recognizes a program as meeting certain predetermined criteria or standards. A formal process for certifying that providers and health plans meet predetermined standards. Accredited Standards Committee X12 (ASC X12) - Group of industry members that creates electronic data interchange standards for submission to the American National Standards Institute for subsequent approval and dissemination. ACS - Ambulatory care services Acute care - Hospital care given to patients who generally require a stay up to seven days and that focuses on a physical or mental condition requiring immediate intervention and constant medical attention; equipment; and personnel AD - Admitting diagnosis ADC - Average daily census Administrative services only (ASO) - Contract between an insurance company or claims administrator and a self-funded plan where the insurance company/claims administrator performs certain services but does not assume any risk; services usually include claims processing but may also include such services as group billing; actuarial analysis; utilization review; and provider network development Admission - Formal registration of a patient who is to be provided with medical care by the provider Admitting diagnosis - Diagnosis provided on admission; explaining the reason for admission and coded according to current diagnosis coding conventions ADP - Automated data processing ADR - Average daily revenue ADRG - Adjacent diagnosis-related group; alternative diagnosis related group ADS - Alternative delivery system ADSC - Average daily service charge ADT - Admission/discharge/transfer Advance Beneficiary Notice (ABN) - The mandated form required to be used for Medicare beneficiaries related to non-covered services. Waiver that a provider has a patient sign confirming the patient's understanding that certain provided services may not be reimbursable under Medicare and therefore are the patient's responsibility. AFDC - Aid to Families with Dependent Children AFDS - Alternative financing and delivery systems Affiliation - Arrangement between organizations by which the named organizations remain independent but have influence on each other; affiliations may or may not be permanent and may not result in common ownership or control of the affiliates. After care - Services following hospitalization or rehabilitation Aging - Process wherein accounts receivable or accounts payable are scheduled; listed; or arranged based on elapsed time from date of service or transaction AHA - American Hospital Association AHP - Allied health professional AHRQ - Agency for Healthcare Research and Quality Aid to Families with Dependent Children (AFDC) - State-based federal cash assistance program for low-income families AIDS Drug Assistance Programs (ADAP) - Joint federal-state sponsored programs that assist eligible HIV-positive patients in obtaining HIV medications ALC - Alternate level of care All inclusive rate - Charge rate established by a healthcare provider that covers all services a beneficiary may receive or be entitled to receive over a designated period of time Allied health personnel - Specially trained and licensed health workers other than physicians; dentists; optometrists; chiropractors; podiatrists; and nurses Allowable costs - Costs incurred by a provider in the course of providing services that are recognized as eligible for reimbursement by a third-party payer Allowance for bad debts - An estimate of the amount of accounts receivable that a healthcare provider will be unable to collect; it reduces the value of accounts receivable. Allowed amount - Maximum amount Medicare will pay in a given area for a covered service ALOS - Average length of stay Ambulatory care - Health services rendered outside the inpatient setting Ambulatory patient group (APG); Ambulatory Payment Classification (APC) - Institutional outpatient reimbursement system based on the methodology developed by CMS; APCs/APGs are to outpatient visits/services what DRGs are to inpatient hospital admissions; the payments are based on categories or groupings of like or similar services requiring like or similar professional services and supply utilization.