medical billing acronyms

Medical Billing and Revenue Cycle Acronyms

A Quick Guide to Billing Department and Revenue Cycle Acronyms

For health systems, hospitals and practice group billing departments, there is an abundance of acronyms commonly used by providers, payers, clearinghouses, banks, technology vendors and outsourcing firms. There are dozens more associated with clinical care and diagnosis that are not included here. Let’s take a look at those you’ll find in working with ReMedics, LLC.  

ABN – Advance Beneficiary Notice
AI – Artificial Intelligence
AOB – Assignment of Benefits
ACS – Ambulatory Care System
ASC – Accredited Standards Committee
ASC – Ambulatory Surgery Center
ACH – Automated Clearing House
BAI – Bank Administration Institute (BAI) file format
BI – Business Intelligence
BPM – Business Process Management
BPO – Business Process Outsourcing
CDM – Charges Description Master
COB – Coordination of Benefits
DCN – Document Control Number
DM – Denial Management (see our Exception Worklists page)
DMS – Document Management Systems
DOS – Date of Service
DSO – Dental Support Organization
ECM – Enterprise Content Management
EDI – Electronic Data Interchange

EDI Examples:
270 – A 270 transaction set is used to transmit eligibility benefit inquiries from healthcare providers, insurers, clearinghouses and other adjudication processors.
271 – A 271 transaction set is the appropriate response mechanism for healthcare eligibility benefit inquiries. It can include information about validations and rejections.
276 – A 276 transaction is used to inquire about the status of a claim after it has been sent to a payer.
277– A 277 transaction is used to respond to a request inquiry about the status of a claim after it has been sent to a payer.

835 – The 835 transaction set is also known as an Electronic Remittance Advice (ERA). It is the electronic transaction that provides claim payment information and documents the EFT (electronic funds transfer).
837 – The 837 transaction set is the electronic submission of medical claim information from care providers to health insurance payers.

EFT – Electronic Funds Transfer
EHR – Electronic Health Record
EMR – Electronic Medical Records
EOB – Explanation of Benefits
ERA – Electronic Remittance Advice
FTS – Funds Transfer System
HDN – Healthcare Delivery Network
HHA – Home Health Agency
HICN – Health Insurance Claim Number
HIPAA – Health Insurance Portability and Accountability Act
HIS – Healthcare Information Systems
HIMS – Health Information Management System
HIT – Healthcare Information Technology
HMO – Health Maintenance Organization
ICN – Internal Control Number
IDN – Integrated Delivery Network
IPO – Integrated Provider Organization
KFI – Key from Image
LOB – Line of Business (Systems)
MBPO – Medical Business Process Outsourcing
MCP – Managed Care Plans
ML – Machine Learning
MRN – Medical Record Number
MSN – Medicare Summary Notice
MSO – Management Services Organization
NPI – National Provider Identifier
OCR – Optical Character Recognition
OON – Out of Network
PA – Pre Authorization
PCN – Primary Care Network
PCP – Primary Care Physician
PIN – Provider Identification Number
PFS – Patient Financial Services
PM System – Practice Management System
PLB – Provider Level Adjustment 
POS – Point of Service
PPO – Preferred Provider Organization
QMB – Qualified Medicare Beneficiary
RA – Remittance Advice
RARC – Remittance Advice Remark Code
RCM – Revenue Cycle Management
RPA – Robotics Process Automation
TCN – Transaction Control Number
TIN – Tax Identification Number
TPA – Third Party Administrators
UPIN – Unique Physician Identification Number
UR – Utilization Review

ReMedics can help to streamline billing processes in your own business office or provide end-to-end, fully integrated payment processing, payment validation, remittance splitting and bank reconciliation services. Contact us online — or call 440-671-7700.