abstracting
: the extraction of specific data from a medical record, often for use in an external
database, such as a cancer registry
abuse
: practices that directly or indirectly result in unnecessary costs to the Medicare
program
account number
: number that identifies specific episode o...
🗸🗸🗸: specifically prohibits any payment by Medicare for services or medically
necessary supplies that are not submitted electronically
administrative services only (ASO) contract
🗸🗸🗸: Contract between employers and private insurers under which employers fund
the plans themselves, and the private insurers administer the plans for the employers.
Advance Beneficiary Notice of Noncoverage (ABN)
🗸🗸🗸: Form provided if a provider believes that a service may be declined because
Medicare might consider it unnecessary.
aging report
🗸🗸🗸: Measures the outstanding balances in each account.
allowable charge
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, 🗸🗸🗸: The amount an insurer will accept as full payment, minus applicable cost
sharing.
APC grouper
🗸🗸🗸: Helps coders determine the appropriate ambulatory payment classification
(APC) for an outpatient encounter.
assignment of benefits
🗸🗸🗸: Contract in which the provider directly bills the payer and accepts the allowable
charge.
auditing
🗸🗸🗸: review of claims for accuracy and completeness
authorization
🗸🗸🗸: Permission granted by the patient or the patient's representative to release
information for reasons other than treatment, payment, or health care operations.
balance billing
🗸🗸🗸: Billing patients for charges in excess of the Medicare fee schedule.
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