Examlex
____________ decisions are based on fact,cognitive knowledge,or quantifiable evidence.
Original Medicare
A federal health insurance program in the United States for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease, consisting of Part A (hospital insurance) and Part B (medical insurance).
Approved Charges
The amounts pre-determined by insurance providers as the maximum they will pay for a covered service or procedure.
X12 837
A standard format for electronically transmitting healthcare claim information from healthcare providers to payers, such as insurance companies.
Electronic Claim
A request for payment for healthcare services that is submitted electronically to a health insurance provider.
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