Medical Billing Software Terms

First Pass Acceptance The amount of claims that are accepted on first pass by the insurance company.

Assignment of Benefits

Insurance payments paid to doctors or hospitals for a patient’s treatment.
Coding Retrieving doctor’s observations from a patient visit and then converting them into diagnosis, ICD-9 code and treatment, CPT code.
Coordination of Benefits When a patient is protected by more than one insurance plan. Assigning one insurance carrier as the primary and another insurance company as the secondary.
Electronic Claim

Claim information is sent electronically from the billing software to the clearinghouse or directly to the insurance carrier. Note: The claim must be sent in electronic format, coded as CPT and ICD-9 code.

Health Insurance Portability and Accountability Act. Federal regulations that made electronic submission of claims mandatory amongst other things intended to improve the efficiency and effectiveness of health care.
Scrubbing The rigorous process of checking an insurance claim for errors before submission.

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