| A | B |
|---|
| New patient | A patient who has not received services from the same provider or a provider of the same specialty or subspecialty within hte same practice for a period of three years |
| Established patient | A patient who has been seen by a provider in the practice in the same specialty or subspecialty within three years |
| Guarantor | an individual who may not be a patient of the practice but who is financially responsible for a patient account |
| Case | A grouping of transactions that share a common element |
| Progress notes | A physician's notes about a patient's condition and diagnosis |
| Referring Provider | A physician who recommends that a patient see a specific physician |
| Primary Insurance carrier | The first carrier to whom claims are submitted |
| Capitated plan | An insurance plan in which prepaymens made toa physician cover the physician's services to a plan member for a specified period of time |
| Crossover claims | Claims that are processed by Medicare and then transferred to Medicaid, or to a payer that provides supplemental insurance benefits to Medicare beneficiaries |
| sponsor | In TRICARE, the active-duty service member |
