If you look at any glossary, you’ll notice an abundance of terms that begin with the letter “s”. A Medical billing and coding glossary is no exception, as there are several important terms that you need to know. For that reason, we are continuing our terminology series in order to make sure that you are fully informed. Here is the medical billing and coding terminology you should know.
The process of reviewing or checking an insurance claim for errors prior to submitting it in order to ensure a clean claim.
Secondary Insurance –
When a patient has more than one health insurance plan, secondary insurance is the one that pays after the primary insurance has met its obligation.
Secondary Procedure –
This happens whenever a provider performs a primary procedure that is covered by a CPT code and then performs another one that is also covered by a different CPT code.
Security Standard –
This was developed by the American Medical Association (AMA) and pertains to procedures used to ensure HIPAA compliance and the security of records that are submitted electronically.
This occurs whenever a patient visits a specialist without being referred by a primary care physician first.
Payment made by the patient or his or her designee at the time services are rendered.
Self-Insured Plan –
One in which the individual covered (or in some cases, an organization) assumes the financial burden of paying for medical care.
Signature on File (SOF) –
Refers to a written signature that is physically on file. This term is typically used whenever an electronic claim is submitted.
Skilled Nursing Facility (SNF) –
A facility such as a nursing home that provides a high level of specialized care for acutely-ill patients. It is used whenever patients need long term or extended care as an alternative to hospitalization.
Software as a Service (SaaS) –
Medical billing software that is hosted on an external server and accessed via the Internet. This type of software is subscribed to on an as-needed basis, and can be accessed from any computer or device that is capable of connecting to the Internet.
A medical bill that is sent from a provider to a patient detailing the charges for services rendered.
This is the digit that comes after the decimal point in ICD codes and is used to describe the nature of an illness or injury in greater detail.
This follows the subcategory and further expands on it by providing information on how a condition began, severity, location or other information that is necessary for completing a claim.
General term used to describe an employee who is part of a group policy.
The form commonly used by a provider to document a patient’s diagnosis and treatment.
Supplemental Insurance –
An additional insurance policy intended to cover charges arising from deductibles and co-insurance. This type of coverage is often used by Medicare patients.
Keeping up to date with important terminology is just as important as keeping up to date with new practices and procedures. Make sure you are fully aware of all the industry terms you need to know by reviewing the entire series. Or, if you would prefer, you can contact us at any time for more information about these terms or medical billing and coding in general.