AAHAM CERTIFIED REVENUE CYCLE PROFESSIONAL
(CRCP) TERMS
3-Day Rule Ans✓✓✓Medicare regulation requiring that certain
outpatient services within 72 hours of an inpatient admission must be
included in the patient's inpatient claim and reimbursed under a DRG.
8371 Ans✓✓✓HIPAA standard transaction used by hospitals to submit
claims electronically.
837P Ans✓✓✓HIPAA standard transaction that replaces the 1500 and is
required of almost all physicians.
838 Ans✓✓✓quarterly Medicare Credit Balance Report
1450 Ans✓✓✓CMS 1450 form; another name for the UB-04.
1500 Ans✓✓✓CMS 1500 form; standard claim form used when a
provider qualifies for a waiver from electronic claims submission; also
used for billing some Medicaid state agencies.
ABN Ans✓✓✓Advance Beneficiary Notice of Noncoverage; a
document given to the patient that states that the provider believes that
Medicare will not or probably will not cover the specified item.
,Abuse Ans✓✓✓incidents or practices that, although not usually
considered fraudulent, are inconsistent with accepted sound medical,
business or fiscal practices, directly or indirectly resulting in
unnecessary costs or improper reimbursement for services that fail to
meet professionally recognized standards of care or that are medically
unnecessary.
Accounts Receivable (AR) Days Outstanding Ans✓✓✓an estimate of
the time needed to collect the accounts receivable.
Accrual Ans✓✓✓a method of accounting in which income is recognized
at the time it is earned, even if not yet collected, and expenses are
booked as they are incurred, even if not yet paid.
ADA Ans✓✓✓Americans with Disabilities Act; a law passed in 1990
that requires employers to make reasonable adjustments to the work site
to accommodate a disabled employee's ability to perform the job and
requires buildings to be accessible to those with disabilities.
ADC Ans✓✓✓average daily census; the total number of patient days in
a given time period divided by the number of days in that period.
ALOS Ans✓✓✓average length of stay; the total number of patient days
divided by the number of discharges.
,Ambulatory Payment Classification Ans✓✓✓a payment methodology
that places outpatient services into groups based on similar procedures
and resource use.
Americans with Disabilities Act Ans✓✓✓a law passed in 1990 that
requires employers to make reasonable adjustments to the work site to
accommodate a disabled employee's ability to perform the job and
requires buildings to be accessible to those with disabilities.
Anticipated value of AR Ans✓✓✓AR balance less the average
deduction from revenue, based on the historical deduction from revenue
rate.
Anti-Kickback Statute Ans✓✓✓a law that prohibits offering free or
discounted services to a physician associated with, or who refers patients
to, another healthcare facility.
APC Ans✓✓✓Ambulatory Payment Classification; a system that places
outpatient services into groups based on similar procedures and resource
use.
AR Ans✓✓✓accounts receivable.
AR Days Ans✓✓✓Days a measure of how long, on average, it takes to
collect revenue from the date of discharge.
, Asset Ans✓✓✓control procedures to protect assets from theft. Assets,
those things a business owns that have a value.
Assignment Ans✓✓✓an agreement that Medicare payments will be sent
to the office rather than the patient; the physician accepts what Medicare
allows as payment in full.
Automated Ans✓✓✓a type of review in which RAC identifies a
potential issue and uses its database to find improper payments; the
provider is then given notification of denied claims.
Average daily census Ans✓✓✓the total number of patient days in a
given time period divided by the number of days in that period.
Average length of stay Ans✓✓✓the total number of patient days divided
by the number of discharges.
Bad debt Ans✓✓✓a deduction from revenue when an account is
determined to be uncollectible.
Balance sheet Ans✓✓✓a financial statement that is a snapshot in time of
the business.
(CRCP) TERMS
3-Day Rule Ans✓✓✓Medicare regulation requiring that certain
outpatient services within 72 hours of an inpatient admission must be
included in the patient's inpatient claim and reimbursed under a DRG.
8371 Ans✓✓✓HIPAA standard transaction used by hospitals to submit
claims electronically.
837P Ans✓✓✓HIPAA standard transaction that replaces the 1500 and is
required of almost all physicians.
838 Ans✓✓✓quarterly Medicare Credit Balance Report
1450 Ans✓✓✓CMS 1450 form; another name for the UB-04.
1500 Ans✓✓✓CMS 1500 form; standard claim form used when a
provider qualifies for a waiver from electronic claims submission; also
used for billing some Medicaid state agencies.
ABN Ans✓✓✓Advance Beneficiary Notice of Noncoverage; a
document given to the patient that states that the provider believes that
Medicare will not or probably will not cover the specified item.
,Abuse Ans✓✓✓incidents or practices that, although not usually
considered fraudulent, are inconsistent with accepted sound medical,
business or fiscal practices, directly or indirectly resulting in
unnecessary costs or improper reimbursement for services that fail to
meet professionally recognized standards of care or that are medically
unnecessary.
Accounts Receivable (AR) Days Outstanding Ans✓✓✓an estimate of
the time needed to collect the accounts receivable.
Accrual Ans✓✓✓a method of accounting in which income is recognized
at the time it is earned, even if not yet collected, and expenses are
booked as they are incurred, even if not yet paid.
ADA Ans✓✓✓Americans with Disabilities Act; a law passed in 1990
that requires employers to make reasonable adjustments to the work site
to accommodate a disabled employee's ability to perform the job and
requires buildings to be accessible to those with disabilities.
ADC Ans✓✓✓average daily census; the total number of patient days in
a given time period divided by the number of days in that period.
ALOS Ans✓✓✓average length of stay; the total number of patient days
divided by the number of discharges.
,Ambulatory Payment Classification Ans✓✓✓a payment methodology
that places outpatient services into groups based on similar procedures
and resource use.
Americans with Disabilities Act Ans✓✓✓a law passed in 1990 that
requires employers to make reasonable adjustments to the work site to
accommodate a disabled employee's ability to perform the job and
requires buildings to be accessible to those with disabilities.
Anticipated value of AR Ans✓✓✓AR balance less the average
deduction from revenue, based on the historical deduction from revenue
rate.
Anti-Kickback Statute Ans✓✓✓a law that prohibits offering free or
discounted services to a physician associated with, or who refers patients
to, another healthcare facility.
APC Ans✓✓✓Ambulatory Payment Classification; a system that places
outpatient services into groups based on similar procedures and resource
use.
AR Ans✓✓✓accounts receivable.
AR Days Ans✓✓✓Days a measure of how long, on average, it takes to
collect revenue from the date of discharge.
, Asset Ans✓✓✓control procedures to protect assets from theft. Assets,
those things a business owns that have a value.
Assignment Ans✓✓✓an agreement that Medicare payments will be sent
to the office rather than the patient; the physician accepts what Medicare
allows as payment in full.
Automated Ans✓✓✓a type of review in which RAC identifies a
potential issue and uses its database to find improper payments; the
provider is then given notification of denied claims.
Average daily census Ans✓✓✓the total number of patient days in a
given time period divided by the number of days in that period.
Average length of stay Ans✓✓✓the total number of patient days divided
by the number of discharges.
Bad debt Ans✓✓✓a deduction from revenue when an account is
determined to be uncollectible.
Balance sheet Ans✓✓✓a financial statement that is a snapshot in time of
the business.
