This is a auto-generated Article of all your definitions within the glossary.
Glossary
This is a auto-generated Article of all your definitions within the glossary.
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835
835, or ERA 835 is the electronic transaction that provides claim payment information.
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Authorization Number
If the procedure requires prior authorization from the insurance company, the authorization number is included. It confirms that the insurance company approved the service or procedure in advance.
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BDD
Body Dysmorphic Disorder
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Billing Provider Information
This includes the name, address, and contact information of the billing provider, which is the entity or individual submitting the claim for reimbursement.
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CDS
Clinical decision support (CDS) provides clinicians, staff, patients or other individuals with knowledge and person-specific information, intelligently filtered or presented at appropriate times, to enhance health and health care. CDS encompasses a variety of tools to enhance decision-making in the clinical workflow. These tools include computerized alerts and reminders to care providers and patients; clinical guidelines; condition-specific order sets; focused patient data reports and summaries; documentation templates; diagnostic support, and contextually relevant reference information, among other tools.
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Claim Adjudication
The process by which a payer reviews and processes a healthcare claim, determining the payment amount based on the terms of the insurance policy.
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Claims Submission
Healthcare providers submit claims to insurance companies or other payers to request reimbursement for the medical services they have provided to patients.
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CLIA Number
The Clinical Laboratory Improvement Amendments (CLIA) Program regulates labs testing human specimens and ensures they provide accurate, reliable, and timely patient test results no matter where the test is done. The provider CLIA Number is issued to any provider who performs laboratory tests on human specimens for the purpose of diagnosis and/or treatment. In Valant, this number is located in the Provider Information tab in Insurance Companies but is not required in most cases.
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Clinical Questionnaire
Clinical questionnaires are used to gather specific information from patients for assessment and treatment purposes. These questionnaires are typically designed to collect data on symptoms, mental health status, medical history, and other relevant information. They also allow you to assign sections of your note to the patient (via MYIO), which you can then review with the patient in the session.
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CMS
Centers for Medicare & Medicaid Services
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CMS-1500 Form
The CMS-1500 is a standardized paper claim form used by healthcare providers, such as physicians, hospitals, and outpatient facilities, to submit claims for reimbursement of medical services to insurance companies, including Medicare and private health insurance carriers. It includes various fields and sections where providers provide detailed information about the services rendered, patient demographics, diagnosis and treatment codes, and other necessary billing details.
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COB
coordination of benefits
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Coinsurance
A cost-sharing approach in health insurance where both the policyholder and the insurer each pay a percentage of covered healthcare costs after the deductible is met. This sharing continues until the out-of-pocket maximum or policy limit is reached, with the insured person responsible for a portion of the expenses.
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Copay (Co-payment)
A copay is a set fee that a patient pays for a covered healthcare service or medication at the time of receiving it, helping share the cost between the patient and the insurer.
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CPT
Current Procedural Terminology (CPT) Codes are five-digit codes that describe the specific medical procedures or services performed by healthcare providers. Each code corresponds to a specific medical service, test, or procedure. They are used by payers to determine the amount of reimbursement.
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CSV
comma-separated values
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Date of Service
This is the date on which the medical service or procedure was performed. It is essential for tracking when healthcare services were provided.
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Deductible
A deductible is the amount a policyholder must pay out of pocket for covered healthcare expenses before their insurance coverage begins.
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Document Templates
Provide an alternative option for clinical documentation during sessions. They open in Microsoft Word, and users can sign them by downloading a Valant Add-in. This feature is optimized for PC users.
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EBV
Enhanced Billing Validation
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EDI
Electronic Data Interchange - identification unique to the insurance company and used to transmit electronic claims, located on the clearinghouse website
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EFT
Electronic Fund Transfer
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EHR
Electronic Health Record
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E&M
E&M codes, or Evaluation and Management codes, are used in medical billing to categorize and bill for different types of patient visits with healthcare providers.
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EOB
Explanation of Benefits -An explanation of benefits (EOB) is the insurance company's written explanation regarding a claim, showing what they paid and what the patient must pay.
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EPCS
Electronic Prescriptions for Controlled Substances
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ERA
Electronic Remittance Advice. An ERA in medical billing is a text-based file that explains what the payer covered, how much they will not pay, and what the patient is expected to pay (for example, co-pays and co-insurance).
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eRx
electronic prescription
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eSignature
The eSignature feature allows practices to streamline the process of obtaining patient signatures electronically, saving time and reducing paperwork.
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Guarantor
In health insurance, the guarantor is the policyholder responsible for paying premiums and covering associated costs. They also handle out-of-pocket expenses for those covered by the policy.
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ICD-10
International Classification of Diseases-Tenth Edition Codes are used to specify the patient's diagnosis or medical condition. ICD-10 codes are alphanumeric and provide a detailed description of the patient's medical condition or reason for seeking medical care.
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IP address
An Internet Protocol address is a numerical label assigned to each device connected to a computer network that uses the Internet Protocol for communication. An IP address serves two main functions: host or network interface identification and location addressing.
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LAC
Logical Access Control: Providers who have completed identity proofing need to get approval from an administrator at a practice before sending controlled substances.
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MFA
Multi-Factor Authentication (MFA) is an authentication method that requires the user to provide two or more verification factors to gain access to Valant.
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Mobile Notes
Valant's note-taking software, not limited to mobile devices, but designed to document sessions.
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Modifiers
Modifiers are additional codes used with CPT or HCPCS (Healthcare Common Procedure Coding System) codes to provide additional information about a service or procedure. For example, modifiers can indicate that a service was performed on both sides of the body or was a repeat procedure.
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NNFL
New Note From Last
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NPI
The provider number or National Provider Identifier is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services. It helps identify the healthcare provider who rendered the services. In Valant, this number is located in the Provider tab in Persons & Institutions | Providers. NPI can be looked up at the following URL: https://npiregistry.cms.hhs.gov/
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OTP
One Time Pin: the number that changes on your soft or hard token
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Outcome Measures
Standardized assessments that help providers measure and track patient progress over time.
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Patient Notifications
Patient Notifications that will pop-up on the screen during various tasks can be attached to any patient. These are internal alerts and will not go to patients via MYIO.
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Patient Record
Patient information which includes the patient's name, date of birth, gender, and insurance information. It provides essential details about the patient receiving the healthcare services.
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Patient Types
Patient Types refer to different categories or classifications that patients can fall into based on certain criteria.
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PDMP
Prescription Drug Monitoring Program
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PHI
Protected Health Information
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POS Codes
Place of Service codes indicate where the medical service was provided. They specify the location, such as an office, hospital, home, or skilled nursing facility, where the healthcare service took place.
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Primary Payer
The insurance company or program primarily responsible for covering the cost of medical services. If a patient is self-pay and does not have insurance, they are considered to be the primary payer.
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Provider Taxonomy Code
This code identifies the healthcare provider's specialty or type of practice. It helps to categorize providers based on their area of expertise or practice.
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PTQ
Pending Transaction Queue
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Referring Provider Information
This includes the name and NPI of the referring provider, if applicable. It indicates the healthcare provider who referred the patient for specific services.
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Rendering Provider Information
If different from the billing provider, this includes the name, address, and contact information of the provider who performed the service. This is the healthcare professional who directly provided the medical care.
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Secondary Payer
An additional insurance company or program that may cover costs not paid by the primary payer.
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SQL
Structured Query Language
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Subscriber Information
If the patient is covered by insurance, this includes the subscriber's name, policy number, and group number. It identifies the primary policyholder and insurance coverage details.
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Taxonomy Code
A taxonomy code is a unique code used in healthcare to categorize providers by specialty or practice type, aiding in claims processing and provider identification.
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Throughput
Throughput can be used to refer to how quickly a computer sends data through its components, including processor and storage devices. It is used in analyzing internet performance to describe the number of data requests handled in a given period by a website server.
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Waystar
Clearinghouse that offers eligibility checking services that are integrated in the Valant EHR.
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Web Editor
A user-friendly feature in Valant that acts like a blank piece of paper, enabling the creation and editing of documents directly within a patient's chart. It facilitates the process of generating clinical notes, progress notes, and other relevant documentation.
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YBOCS
Yale-Brown Obsessive-Compulsive Scale