| A | B |
|---|
| Account aging | The process of finding how long specific account balances have been outstanding. |
| Accounts payable | The outstanding bills of a business, such as a medical office |
| Accounts receivable | Total amount owed to a business for goods and services. |
| Aging process | Process of determining how long specific account balances have been outstanding. |
| Ambulatory payment classification | Service classification system that the Center for Medicare and Medicaid Services developed for facility reimbursement of hospital outpatient services. It is intended to simplify a the outpatient hospital payment system, ensure the payment is adequate to compensate hospital costs, and implement deficit-reduction goals of the CMS. |
| Average length of stay (ALOS) | Predetermined number of days of approved hospital stay assigned to an individual diagnosis-related group (DRG). |
| Balance due | Total amount owed. |
| Bankruptcy | Legal process by which the debts of an individual or business are resolved if they cannot be paid. |
| Business associate | Defined by the Health Insurance Portability and Accountability Act (HIPAA) |
| Capitation | A method of paying for insurance in which a fixed amount is paid to the provider per member for a specific time period regardless of the amount of care. |
| Case-mixed adjustment | The adjustment or modification of the health condition, taking into consideration the clinical characteristics and services needs of the beneficiary. |
| Cash basis of accounting | Accounting method in which income is entered when payment is received. |
| Cashier's check | A check drawn on a bank instead of an individual account. |
| Certified check | A check on an individual account that a bank assumes responsibility for, usually by withdrawing funds to cover the check from the checking account at the time the check is certified. |
| Charge slip | A form used to keep track of charges and payments at the time of a patient visit. |
| Claim message | Messages encouraging payment of a bill, usually attached to or printed on the monthly statement. |
| Collection agency | A firm that is in the business of collecting overdue accounts. |
| Co-morbidity | Presence of more than one disease or disorder that occurs in an individual at the same time. |
| Contractual write-off | When the provider agrees, through a contractual agreement, not to be paid the remaining amount of a fee after the patient has paid his or her deductible and coinsurance and all third-party payers have paid their share. |
| Credit | A posting that is subtracted from an account balance. |
| Credit balance | A negative balance on a patient account (i.e., money owed by the medical office), usually because of an over-payment. |
| Cycle billing | Time between bills. |
| Debit | A posting that is added to an account balance. |
| Diagnosis-related group (DRG) | A system to determine Medicare reimbursement for a hospital stay on the basis of the patient's diagnosis. |
| Disbursements | Money paid out. |
| DRG grouper | A computer software program that takes the coded information and identifies the patient's diagnosis-related group (DRG) category. |
| Fair Debt Collection Practices Act | Act that prohibits certain abusive methods used by third-party collectors hired to collect overdue bills. |
| Fee schedule | List of charges (fees) for specific procedures that may be performed in a medical office. |
| Fee-for-service | A means of payment for health care in which reimbursement for each service provided is made in full or part. |
| Invoice | An itemized bill for items that have no been prepaid. |
| Ledger | A book, card or computer account used to record financial transactions. |
| Liabilities | Legal responsibilities in accounting in the amount owed by the business to the creditor. |
| MICR line | A line of numbers containing the ABA transit routing number and the account number that appears at the bottom left of a check. These numbers are read by a magnetic ink character recognition (MICR) system. |
| Non-labor component | One of the two figures used for calculating DRG payments. The DRG weight is a multiplied by a standardized amount, which is the sum of a non-labor component that represents a geographic calculation based on whether the hospital is located in a large urban or other area and a labor component that is adjusted by a wage index. |
| Overdraft | A check ( or draft) that exceeds the amount of funds in a bank account. |
| Overdraft protection | A line of credit that banks offer to the customer to cover overdraft. |
| Patient ledger | Chronologic accounting of activities of a particular patient (or family) including all charges and payments. |
| Payee | The person to whom a check is made out. |
| Per Diem rates | Actual cost per day. |
| Petty cash | A cash account kept in a business office to pay for incidentals, such as postage due and other small items. |
| Principle diagnosis | Reason for admission to the acute care facility. |
| Prospective payment system (PPS) | Medicare reimbursement system for inpatient hospital cost based on predetermined factors and not on individual services. Rates are set at a level intended to cover operating costs for treating a typical inpatient in a given DRG. Payment for each hospital are adjusted for various factors, such as differences in area wages, teaching activity, and care to the poor. |
| Reconciling | Making sure that two financial records agree, such as bank statement and bank balance. |
| Reimbursement | Payment to an insured individual for a covered expense or loss experienced by or on behalf of the insured. |
| Relative value scale (RVS) | Method determining reimbursement for medical services on the basis of establishing a standard unit value for medial and surgical procedures. RVS compares and rates each individual service according to the relative value of each unit and converts this unit value to a dollar value. |
| Residential healthcare facility | Facility that provides custodial care to persons who, because of physical, mental, or emotional disorders are not able to live independently. |
| Short-stay outlier | Adjustment to the federal payment rate for long-term care hospital (LCTH) stays that are considerably shorter than the average length of stay for an LTCH diagnosis-related group (DRG). |
| Skip | Account for which no billing information is available. |
| Super-bill | An itemized charge slip usually also containing diagnosis codes and procedure codes required for insurance billing. |
| Truth in Lending Act | Requires the person or business entity to disclose the exact credit terms when extending credit to applicants and regulates how they advertise consumer credit. |
