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Adjudication
The final determination of the issues involving settlement of an insurance claim.
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Adjustment
The portion of medical bill that doctor or hospital has agreed not to charge Patient.
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Aging
Any claims or unpaid insurance that are due past 30 days.
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AMA
American Medical Association. The largest consortium of doctors in the US. Their publication: American Medical Association is a widely distributed medical journal in the world.
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Ambulatory Care
It includes all types of health services that do not require an overnight hospital stay.
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Ancillary Service
Services you need beyond room and board charges, such as laboratory tests, therapy, surgery and the like.
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Appeal
A process by which a doctor or the Patient can object to payer when they disagree with the health plan's decision not to pay for care provided.
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AR
(Accounts Receivables) It’s a term used to indicate outstanding amount of money that the hospital or physician are still hoping to get paid for.
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Assignment of Benefits
Insurance payments which are sent directly to the patient’s doctor or hospital
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Authorization
Approval of care required before a service is provided. Pre-authorization may be necessary before hospital admission, or before care is given by non-HMO providers.
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