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Process and settlement of the healthcare claim by the insurance payer

Objection by the insurance payer

Insurance payment to the provider

Person covered by the insurance policy        

Service for checking, correcting and transmitting claims to the insurance payer  

Payable amount by the patient for each provider visit 

Payable percentage (%) amount by the patient

Abbreviations & symbols used in ICD

Patient is covered in more than one insurance policy

Current procedural terminology (6 chapters / primary 5-digit code)       

Provider application to participate in the insurance policy

Claim information is automatically sent from primary to secondary insurance

Standard medical claim form to submit claims to insurance payer

Provider record of daily treatments, charges and payments 

Payable amount by the patient prior beginning of insurance coverage

Electronic health record

Electronic medical record

Superbill - medical form used by the provider for registering patient treatments  

Explanation of benefits / insurance statement about payable services

Electronic remittance advice / insurance statement about payment amount

Evaluation and management of CPT codes

Health information portability and accountability act

International classification of disease (3-4-5 digits)

(states codes for injury, disease​, conditions, signs & symptoms)

E-codes (ICD): codes for external causes of injury & poison

V-coces (ICD): codes for encounters other than injury & poison

1 or 2 digits after 5 digit main codes / indicates additional treatment information