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CERTIFIED REVENUE CYCLE SPECIALIST DEFINITIONS(Verified Questions and Answers )
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CERTIFIED REVENUE CYCLE SPECIALISTDEFINITIONS(Verified Questions and
Answers )
A requirement that all diagnostic or outpatient services furnished in connection with the
principle admitting diagnosis within one day prior to the hospital admission are bundled
with the inpatient services for Medicare billing - ANS-1-Day Rule
A requirement that all diagnostic or outpatient services furnished in connection with the
principle admitting diagnosis within three day prior to the hospital admission are bundled
with the inpatient services for Medicare billing - ANS-3-Day Rule
The American National Standards Institute transaction for a professional claim (the
electronic equivalent of the CMS 1500), formerly the 837P - ANS-5010A1
The American National Standards Institute transaction for an institutional claim; as a
result of HIPAA, it is replacing the electronic UB-04 - ANS-837I
A former American National Standards Institute transaction for a professional claim (the
electronic equivalent of the CMS 1500)since replaced by the 5010A1 - ANS-837P
The Advance Beneficiary Notice of Noncoverage; a form given to a Medicare
Beneficiary before services are furnished when a service does not meet or is not
expected to meet medical necessity. - ANS-ABN
The misuse of a person, substance, service, or financial matter such that harm is
caused; some forms of healthcare abuse include excessive or unwarranted use of
technology, pharmaceuticals, and services; abuse of authority; and abuse of privacy,
confidentiality, or duty to care; it also includes improper billing practices (like billing
Medicare instead of primary insurer), increasing charges to Medicare beneficiaries but
not to other patients, unbundling of services, and unnecessary transfers of patients. -
ANS-ABUSE
An estimate, using average current revenues, of the days required to turn over the
accounts receivable under normal operating conditions; in simple terms, this is an
,estimate of the time needed to collect the accounts receivable. - ANS-ACCOUNTS
RECEIVABLE (AR) DAYS OUTSTANDING
Administration for Children and Families; one of the DHHS Operating Divisions. -
ANS-ACF
Administration for Community Living; one of the DHHS Operating Divisions. - ANS-ACL
Written or oral agreement by the patient to the treatment outlined - ANS-ACTUAL OR
EXPRESSED CONSENT
A level of healthcare delivered to patients experiencing acute illness or trauma; it
generally occurs in a hospital or emergency room and is generally short-term care
rather than long-term or chronic care. - ANS-ACUTE INPATIENT
Average daily census; the average number of inpatients maintained in the hospital each
day for a specific period of time. - ANS-ADC
Average Days of Revenue in Accounts Receivable; also known as Accounts Receivable
(AR) Days Outstanding; an estimate, using average current revenues, of the days
required to turn over the accounts receivable under normal operating conditions; in
simple terms, this is an estimate of the time needed to collect the accounts receivable. -
ANS-ADRR
The Advance Beneficiary Notice of Noncoverage; a form given to a Medicare
beneficiary before services are furnished when a service does not meet or is not
expected to meet medical necessity - ANS-ADVANCE BENEFICIARY NOTICE
Aid to families with Dependent Children: a financial assistance program provided by
DHHS - ANS-AFDC
Individuals who help consumers and small businesses complete the application process
and enroll in healthcare coverage through the Marketplace; they are able to make
recommendations about coverage and may only sell plans from specific health
insurance companies. Compensated by Health Insurance Companies. Service is free to
all consumers. - ANS-AGENTS
The American Hospital Association - ANS-AHA
Agency for Healthcare Research and Quality; one of the DHHS Operating Divisions -
, ANS-AHRQ
Average length of stay; a metric calculated by dividing the total number of patient days
by the number of discharges. - ANS-ALOS
Services other than routine room and board charges that are incidental to the hospital
stay; they include operating room; anesthesia; blood administration; pharmacy;
radiology; laboratory; medical, surgical, and central supplies; physical, occupational,
speech pathology, and inhalation therapies ; and other diagnostic services.. -
ANS-ANCILLARY SERVICES
The American National Standards Institute - ANS-ANSI
Ambulatory payment classifications; a payment methodology in which services paid
under the prospective payment system are classified into groups that are similar
clinically and in terms of the resources they require; a payment rate is established for
each APC. - ANS-APC
Annual percentage rate; one of the elements of disclosure required by the Truth and
Lending Act - ANS-APR
A written authorization, signed by the policyholder (or the patient, in the absence of the
policyholder) to an insurance company, to pay benefits directly to the provider; when
assignment is not accepted, the payment will be sent to the patient and the provider will
have to collect it. - ANS-ASSIGNMENT OF BENEFITS
Aged trial balance; a resource for internal collection efforts - ANS-ATB
Agency for Toxic Substances and Disease Registry; one of the DHHS Operating
Divisions. - ANS-ATSDR
The average number of inpatients maintained in the hospital each day for a specific
period of time. - ANS-AVERAGE DAILY CENSUS
The average amount of revenue or charges generated each day over a specified period
of time. - ANS-AVERAGE DAILY REVENUE
Also know as Accounts Receivable (AR) Days Outstanding; an estimate, using average
current revenues, of the days required to turn over the accounts receivable under
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