Next up in our series of some important medical billing industry terms is our post about terms that begin with the letter “D.” There are only a few of them this time, but that doesn’t mean these terms are not important ones to know. Read on to learn the medical billing and coding terminology you should know beginning with (D).
1. Date of Service (DOS):
The actual date on which health care services were provided to the patient by a doctor or hospital.
2. Deductible:
The amount of money a patient is required to pay out of his or her pocket before insurance coverage actually begins. For example, a plan with a $1,500 deductible would require an individual to incur more than that amount before coverage would kick in.
3. Denial:
The refusal of an insurance company to pay a claim. Denials are based on a number of factors, and can typically be appealed by the provider.
4. Department of Health and Human Services (DHHS):
The government agency responsible for overseeing Medicare and Medicaid programs. It is the parent organization of the Center for Medicare and Medicaid services (CMS).
5. Dependents:
Individuals who are also covered under a health plan along with the primary insured. Examples of dependents include spouses and children.
6. Diagnosis Code (Dx):
Codes that are used to identify diseases, disorders and other health conditions for treatment purposes. These may be either ICD-9 or ICD-10 codes.
7. Down-coding:
This occurs whenever an insurance company reduces the medical code on an invoice in order to reduce the amount of money being paid to the provider. This is typically done whenever there is inadequate documentation to support the service claimed by the provider, and may be performed automatically by the carrier’s software program.
8. Duplicate Coverage Inquiry (DCI):
A request by an insurance company in an effort to find out whether or not other coverage for a patient actually exists. This is often needed to determine which coverage is secondary and which one is primary and to prevent duplicate payments.
9. Durable Medical Equipment (DME):
Medical equipment that is durable in nature because it is designed to withstand multiple uses. Durable medical equipment is not disposable, and typically has no usefulness outside of treating a particular illness or injury. Examples of durable medical equipment include oxygen tanks and wheelchairs.
This series of posts of medical billing terminology should help you get acquainted with industry jargon. If you are unsure as to what a term might mean, please feel free to ask anyone at M-Scribe for help. If you’re struggling to keep up with all the medical billing and coding terms that are out there, perhaps you should consider outsourcing these functions to someone else. Here at M-Scribe, we can take care of your medical billing and coding needs very affordably, and we invite you to contact us to find out more about the services we offer.
{{cta(’39a5381b-9ccb-43fb-a2eb-ddef8c57a968′,’justifycenter’)}}