1. Peer review - your physician can appeal a peer review, in other words they can call in and speak to an associated physician at the insurance company to deliberate medical needs.
2. Open/Pending claims - claims that have not yet accomplished the claims processing cycle. Open claims may have been lately submitted, re-submitted, or drew; whatever the situation, they have not been accomplished.
3. Medicare and mediaid records should be retained for at least 5 years.
4. Explanation of benefits - is a proclamation issued by a health insurance firm to their insured entities enlightening what medical actions/ services remunerated for on their behalf.
5. Financial Responsibility Form - this refers to money you are accountable for paying to someone when you cause indemnities or wounds in an accident.
6. Encounter Form – a main constituent in precise billing and collections. They document services given by taking the analysis and procedure codes, which help as the foundation for billing and receipt of imbursement for services.
7. Third Party Payers - Any group, public or private, that recompenses or protects health or medical expenses on behalf of recipients or beneficiaries, for example commercial insurance companies, Medicare, and Medicaid.
8. Hippa - it stands for Health Insurance Portability and Accountability Act. It is a federal rule that arrays a national standard to safeguard medical records and other personal health data.
9. Claims Log – it is just simply known as catalogue of claims.
10. Appeal - If your health insurer declines to recompense a claim or ends your coverage, you have the right to appeal the choice and have it studied by a third party. Appeal is a serious or urgent request.