Intro to the revenue cycle Flashcards
cash flow
- movement of monies into or out of a business
accounts receivable
- monies owed to a medical practice
accounts payable
- a practice’s operating expenses
revenue cycle
- all administrative and clinical functions that help capture and collect patient’s payment for medical expenses
health information technology (HIT)
computer information systems that record, store, and manage patient information
practice management program (PMP)
accounting software used for scheduling appointments, billing, and financial record keeping
electronic health record (EHR)
computerized lifelong healthcare record for an individual that incorporates data from all sources
PM/EHR
software program that combines both a PMP and an EHR into a single product
medical insurance
a written policy stating the terms of an agreement between a policy holder and a health plan
policyholder
person who buys an insurance plan
health plan
individual or group plan that provides or pays for medical care
benefits
health plan payments for covered medical services
payer
health plan or program
third-party payer
private of government organization that insures or pays for healthcare on behalf of beneficiaries
schedule of benefits
list of medical expenses covered by a health plan
medical necessity
payment criterion that requires medical treatments to be appropriate and provided in accordance with generally accepted standards
provider
person or entity that supplies medical or health services and bills for, or is paid for, the services in the normal course of business
covered services
medical procedures and treatments that are included as benefits in a health plan
preventive medical services
care provided to keep patients healthy or prevent illness
noncovered services
medical procedures that are not included in a plan’s benefits
excluded services
services not covered in a medical insurance contract
