KEY TERMS
accounts payable (AP)
accounts receivable (AR)
benefits
cash flow
certification
coding
coinsurance
copayment
covered services
deductible
diagnosis
documentation
electronic claim (e-claim)
electronic health record (EHR)
fee-for-service
health care claim
health information technology (HIT)
health plan
indemnity plan
managed care
managed care organization (MCO)
medical assistant
medical billing cycle
medical documentation and billing cycle
medical insurance
medically necessary
noncovered (excluded) services
out-of-pocket
PM/EHR
policyholder
practice management program (PMP)
preauthorization
premium
procedures
provider
remittance advice (RA)
revenue cycle management (RCM)
statement
third-party payer
Patients who come to physicians’ practices for medical care are obligated to pay for the services
they receive. Some patients pay these costs themselves, while others have medical insurance to
help them cover medical expenses. Administrative staff members help collect the maximum
appropriate payments by handling patients’ financial arrangements, billing insurance companies,
and processing payments to ensure both top-quality service and profitable operation.
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