| A | B |
|---|
| birthday rule | parent whose birthday is first becomes primary insurance |
| coordination of benefits | more then ! insurance clause |
| diagnosis codes | disorder and disease classification |
| current procedural termonology | services and TX |
| ICD-9 | international classicfication diseases |
| CPT | current procedural termonology |
| encounter | various forms |
| established patient | seen within last 3 years |
| Treatments or record release | need written authorization |
| authorization forms | signed and dated by adult |
| encounter forms | lists DX procedures and charges |
| PHI | name phone SS# DOB address |
| TPO | TX payment operations |
| policyholder | subscriber, gurantor insured |
| gender rule | may be used instead of birthday rule, male parent |
| authorization number | certification number |
| encounter form | super bill |
| self pay | insured patient |
| to post | enter info into program |
| Eligibility for a Health Plan | HIPAA used tocheck pts insurance |
| HIPPA primary to secondary payer | coordiantion of benefits |
| preregistration process | collect PHI b4 appointment |
| Assignment of benefits, medical HX, Pt info | forms pt completes |
| assignment of benefits | dr files claims to get paid |
| receipt of notice of privacy practices | how provider protects PHI |
| 2 insurance plan coverage | one in effect longest |
| employee plan and Govt plan | employees plan primary |
| insurance "v" government plan | private insurance primary |
| NonPAR | nonparticipating |
| supplemental insurance | picks up or fills in the gap |
| primary secondary tertiary | order of insurance |
| patient ledger | records financial transaction |
| referra certification and authorization | HIPAA transaction prior approval from payer |
