In this installment of our blog series, we’ll continue to explore important medical billing and coding industry terms because you can’t master a business without understanding the lingo. In this episode, we will focus on the letter “e”. Here are some of the most important medical billing and coding terms you should know.
These codes are a part of the ICD-9 system and refer to external causes of injury.
Effective Date –
A date that a final rule is effective under HIPAA, typically 60 days after being published in the Federal Register.
Electronic Claim –
A claim sent electronically to the insurance carrier or payment clearinghouse using billing software.
Electronic Claim Enrollee –
A covered individual for whom electronic claims are submitted.
Electronic Data Interchange (EDI) –
The exchange of claims information between computers using standard communication protocols.
Electronic Funds Transfer (EFT) –
An electronic method of transferring payment between the payer and provider that eliminates the need for paper checks. Electronic funds transfers allow for more timely and accurate payments.
Electronic Remittance Advice (ERA) –
An electronic method of explaining the payment of health care claims. An ERA can be in one of several different formats.
Employee Benefits Security Administration (EBSA) –
Government agency responsible for regulating and enforcing Title 1 of the Employee Retirement Income Security Act (ERISA).
Employee Retirement Income Security Act (ERISA) –
A 1974 law that established the appeals requirements, financial standards, and reporting of grievances for group life and health plans.
Employer Group Health Plan (EGHP) –
A plan offered by an employer that provides healthcare coverage to employees and their families.
Employer Identification Number (EIN) –
A tax identification number given to an employer to help identify it.
A person who is covered by medical insurance.
An Exclusive Provided Organization or EPO occurs whenever an employer agrees not to contract with any other plan. It is a type of managed care plan that combines PPOs and HMOs.
Errors and Omissions Insurance –
Liability insurance taken out by medical professionals to cover them for errors that might result in financial harm to another party.
Evaluation and Management (E/M) –
CPT codes 99201 thru 99499 that are a part of the Evaluation and Management section, and used to evaluate a patient’s treatment needs.
Explanation of Benefits (EOB) –
A statement provided by the insurance company that details covered charges, patient responsibilities and deductions, among other things.
Things that are not covered by Medicare.
Of course, these terms are not all-inclusive, as there are actually several others beginning with the letter “e” that are often used as well. Fortunately, you don’t have to keep up with all the terminology because our team of professionals is already familiar with all the different terms. Allow your medical billing and coding functions to be handled with ease, and eliminate the worry of hassle from your daily life. They are many more important things to worry about anyway. Please feel free to contact us at any time to learn more information about the services we offer.