Healthcare Billing Terms and Form Names

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Can you name the Healthcare Billing Terms and Form Names?

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DefinitionTerm
A Medicare policy to determine what is and what is not covered for an encounter. It is based on medical necessity.
An electronic request for claim status. Sent by provider to payor.
Codes which charge for the procedures performed in an outpatient setting.
Codes which charge for supplies and equipment used in an outpatient setting.
A code used to charge for procedures performed in an inpatient stay.
Professional Billing claim in the paper format.
System developed my CMS to promote national coding methodologies and reduce duplicate entries
Hospital Billing claim in the paper format.
A document from the payor explaining what invoices are being paid and why.
DefinitionTerm
A code that identifies a specific accomodation or service. It is a group of individual charges. Payors will either pay the whole claim, or they'll pay for each of these charges.
Both edit-checks a claim and determines its medium (paper or electronic)
A designation that Medicare gives to qualifying organizations which allows them to bill Medicare on UB and 1500--not just on one CMS form.
A Diagnosis-related charge for inpatient stays. Only one may be assigned to a patient.
Medicare's identification number it assigns to each claim received to keep track of it.
An electronic response to a request for claim status. Sent from payor back to provider.
A diagnosis-related charge for an outpatient visit. Patients can have multiple groups of these charges.
Professional AND Hospital Billing claim in the electronic format.
Electronic form of remittance advice.

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