Across
- 1. Process for recovering overpayment to a patient or provider
- 4. Process of creating a new claim from one previously submitted to record as a duplicate or correct information
- 6. Electronic claim form
- 7. Date the claim or pre-authorization is settled by claims
- 9. Any claim submitted to by a provider for the same service provided to a patient on a specified date that was included in a previously submitted claim
- 14. Period of time a patient needs to wait before they become eligible for coverage or a specific service under a plan
- 15. Coverage options that enable a patient to expand basic insurance plan for an additional premium
- 18. Codes used to document medical procedures
- 19. Codes used to explain reasons why a claim was paid or denied
- 22. Internal clearinghouse used by Avesis
- 23. Codes used to document dental treatment
- 24. Process of evaluating a claim for payment of benefits
Down
- 2. Replacement of a previously submitted claim to fix incorrect or missing information
- 3. Amount a patient owes a Provider after the insurance company has paid their portion of a claim
- 5. Code indicates claim received through clearinghouse
- 8. Company providing electronic submission and translation services between providers and insurance companies
- 10. Form providing common format for reporting dental services to a patient's plan
- 11. Benefits statement sent to Member and Provider after a claim is processed
- 12. Two-digit codes that provide additional information about a billed procedure
- 13. Comprehensive listing of fee maximums used to reimburse providers on a fee-for-service basis
- 16. Payment statement sent to Provider after a claim is processed
- 17. Person who decides whether a patient's insurance policy covers a medical procedure
- 20. Any specific situation, condition or treatment that a health insurance plan does not cover
- 21. Allows Providers to submit electronic attachments with claims