Accounts Receivable

open account

accounts that are subject to charges from time to time

adjustment

the amount corrected on a patient ledger due to an error or the difference in the amount billed by a practice and the amount allowed by the insurance company for payment of a claim

Co-payment

the amount that the insured has to pay toward the amount allowed by the insurance company for services

deductible

the amount that the insured must pay before the insurance company will begin benefit payments

conversion factor

the dollar amount determined by dividing the actual charge of a service or procedure by a relative value

collection ratio

the relationship between the amount of money owed and the amount of money collected

Inquiry

Checking or tracing a claim sent to an insurance company to determine payment or processing

EOB

Explanation of benefits

EOMB

Explanation of medicare benefits

RBRVS

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accounts receivable

A/R, the total amount of money owed to the physician for professional services provided to a patient

accepting assignment

The provider of services agrees or is willing to accept as payment the amount allowed/approved by an insurance company as the maximum amount that will be paid for the claim

professional courtesy

a discount or fee exception given to a patient at the discretion of the physician

profile

a list of CPT codes used by the physician with a corresponding fee that is usually calculated and maintained by a third party payer

posting

a process of transferring account information from a journal to a ledger

ledger card

a record to track patient charges, payments, adjustments, and balances due

Dun/dunning

a request or message to remind a patient that the account is over due or delinquent

appeal

a request sent to an insurance company or other payer asking that a submitted claim be reconsidered for payment or processing

Accounts payable

amounts owed by the practice to creditors for property, supplies, equipment

fee schedule

an established price set by a medical practice for professional services

aging accounts

analysis of accounts receivable that indicate delinquency of 60, 90, to 120 days

assignment

authorization by a policy holder to allow a third party payer to pay benefits to a health care provider

cycle billing

breaking the account receivable amounts into portions for billing at a specific date of the month

limiting charge

typically applies to medicare reimbursement. this is the absolute maximum fee a physician may charge a medicare patient when not accepting assignment on the claim