Patients & Visitors at Fairbanks Memorial Hospital  

Glossary of Billing Terms

 

-A- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Account - Charges for a medical visit
  • Account Number - Number given by a doctor or hospital for a medical visit
  • Adjustment - The portion of a medical bill for which a doctor or hospital has agreed not to charge
  • Admission Date (Admit Date) - Date patient admitted for treatment
  • Admission Hour - Hour when admitted for inpatient or outpatient care
  • Admitting Diagnosis - Words that a doctor uses to describe a medical condition
  • Advance Beneficiary Notice (ABN) - A notice the hospital or doctor gives before treating a Medicare patient, telling them that Medicare will not pay for some treatment or services. The notice is given so that Medicare patients are aware of non-covered treatment or services, and may decide before treatment is provided whether to proceed with the treatment and how to pay for it
  • Advance Directive (Healthcare) - Written prior to treatment, a healthcare advance directive is a document that says how a patient would like medical decisions to be made if the patient loses the ability to make decisions. A healthcare advance directive may include a living will and a durable power of attorney for health care
  • Amount Charged - The amount a doctor or hospital bills a patient
  • Amount Not Covered - What an insurance company does not pay. It includes deductibles, co-insurances and charges for non-covered services.
  • Amount Paid - The dollar amount a patient pays for a doctor or hospital visit
  • Amount Payable by Plan - How much an insurer pays for patient treatment, minus any deductibles, coinsurance or charges for non-covered services
  • Anesthesia - Drugs given to a patient during surgery to eliminate or reduce pain resulting from the surgical procedure
  • Appeal - The process by which a patient, doctor, or hospital can disagree with the health plan's decision to not pay for care
  • Applied to Deductible - Portion of a patient's bill, as defined by an insurance company, that he or she owes a doctor or hospital
  • Attending Physician Name - The doctor who certifies that a patient needs treatment and is responsible for the patient's care
  • Assignment - An agreement a patient signs that allows an insurance company to pay a doctor or hospital
  • Assignment of Benefits (AOB) - When insurance payments are sent directly to a doctor or hospital
  • Authorization Number - A number stating that a patient's treatment has been approved by his or her insurance plan. Also called a certification number or prior-authorization number

-B- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Balance Bill - How much doctors and hospitals charge a patient after the patient's health plan, insurance company or Medicare has paid its approved amount
  • Beneficiary - Person covered by health insurance
  • Beneficiary Eligibility Verification - A way for doctors and hospitals to get information about whether a patient has insurance coverage
  • Beneficiary Liability - A statement that a patient is responsible for some treatments or charges
  • Benefit - The amount an insurance company pays for medical services
  • Bill/Invoice/Statement - Printed summary of a medical bill

-C- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Claim - A medical bill that is sent to an insurance company for processing
  • Claim Number - A number given to a medical service
  • Coinsurance - The cost-sharing part of a bill that a patient has to pay
  • Co-pay - Agreed amount of the charges for medical services that patients or guarantors must pay
  • Consent (for treatment) - An agreement signed by a patient giving permission to receive medical services or treatment from doctors or hospitals
  • Contractual Adjustment - A part of a patient's bill that a doctor or hospital must write-off (not charge for) because of billing agreements with the insurance company
  • Coordination of Benefits (COB) - A way to decide which insurance company is responsible for payment if a patient has more than one insurance plan
  • Co-payment - A cost-sharing part of a bill that is a patient's responsibility to pay, also known as co-pay
  • Covered Benefit - A health service or item that is included in a health plan, and that is paid for either partially or fully
  • Covered Days - Days that an insurance company pays for in full or in part

-D- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Deductible - How much cost-sharing a patient must pay for medical services, often before the insurance company starts to pay
  • Discharge Hour - Time of day when a patient was discharged

-E- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Enrollee - A person who is covered by health insurance
  • Explanation of Benefits (EOB/EOMB) - The notice received by a patient from an insurance company after receiving medical services from a doctor or hospital. It details what was billed, the payment amount approved by insurance, the amount paid, and the amount to pay

-F- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Financial Assistance - Assistance for patients who have financial hardship and difficulty paying their medical bill

-G- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Guarantor - The person responsible for paying the patient's bill. Typically, the guarantor is the patient's parent or guardian

-H- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Healthcare Provider - Someone who provides medical services, such as doctors, hospitals or laboratories. This term should not be confused with insurance companies, that provide insurance
  • HIPAA - Health Insurance Portability and Accountability Act. This federal act sets standards for protecting the privacy of patient health information
  • Home Health Agency - An agency that treats patients in their homes

-I- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Insured Group Name - Name of the group or insurance plan that insures an individual, usually an employer
  • Insured Group Number - A number that an insurance company uses to identify the group under which a patient is insured
  • Insured's Name (Beneficiary) - The name of the insured person

-N- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Non-Covered Charges - Charges for medical services denied or excluded by an insurance company. A patient may be billed for these charges
  • Non-Participating Provider - A doctor, hospital or other healthcare provider who is not part of an insurance plan's doctor or hospital network

-O- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Out-Of-Pocket Costs - Costs a patient is responsible for because their insurance does not cover them

-P- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Paid To Provider - Amount the insurance company pays a medical provider directly
  • Paid To You - Amount the insurance company pays the patient or guarantor
  • Participating Provider - A doctor or hospital that agrees to accept an insurance payment for covered services as payment in full, minus the patient's deductibles, co-pays and coinsurance amounts
  • Patient Amount Due - The amount charged by a doctor or hospital for which the patient is responsible
  • Pre-Existing Condition - A health condition or medical problem that a patient already has before receiving insurance. Some health insurers may not pay for pre-existing health conditions
  • Pre-payments - Money a patient pays before getting medical care; also referred to as pre-admission deposits

-R- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Release of Information - A signed statement from a patient or guarantor that allows doctors and hospitals to release medical information

-S- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Secondary Insurance - Extra insurance that may pay some charges not paid by a patient's primary insurance company. Whether payment is made depends on insurance benefits, insurance coverage and benefit coordination

-T- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • Total Charges - Total cost of medical services

-U- Jump to: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

  • U4 - A form used by hospitals to file insurance claims for medical services

Return to Patient Financial Services

Fairbanks Memorial Hospital & Denali Center
1650 Cowles St.
Fairbanks, AK 99701
(907) 452-8181
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