CRCR Glossary Terms
AAR - answerAfter-hours activity report
ABN - answerAdvance Beneficiary Notice
ACC - answerAmbulatory care center
Access - answerAbility to receive hospital; physician or other medical services without
regard to an individual's ability to pay
Accounts receivable (A/R) - answerMoney owed to an organization for goods or
services furnished
Accounts receivable (A/R) collection period - answerNumber of days in the accounting
period divided by accounts receivable turnover. This ratio tells you the average time it
takes to collect amounts due.
Accounts receivable (A/R) turnover - answerServices rendered on credit during the
period divided by the A/R balance. This ratio tells you how many times you collect your
AR in a given cycle.
Accreditation - answerFormal process by which an agency or organization evaluates
and recognizes a program as meeting certain predetermined criteria or standards. A
formal process for certifying that providers and health plans meet predetermined
standards.
Accredited Standards Committee X12 (ASC X12) - answerGroup of industry members
that creates electronic data interchange standards for submission to the American
National Standards Institute for subsequent approval and dissemination.
ACS - answerAmbulatory care services
,Acute care - answerHospital care given to patients who generally require a stay up to
seven days and that focuses on a physical or mental condition requiring immediate
intervention and constant medical attention; equipment; and personnel
AD - answerAdmitting diagnosis
ADC - answerAverage daily census
Administrative services only (ASO) - answerContract between an insurance company or
claims administrator and a self-funded plan where the insurance company/claims
administrator performs certain services but does not assume any risk; services usually
include claims processing but may also include such services as group billing; actuarial
analysis; utilization review; and provider network development
Admission - answerFormal registration of a patient who is to be provided with medical
care by the provider
Admitting diagnosis - answerDiagnosis provided on admission; explaining the reason for
admission and coded according to current diagnosis coding conventions
ADP - answerAutomated data processing
ADR - answerAverage daily revenue
ADRG - answerAdjacent diagnosis-related group; alternative diagnosis related group
ADS - answerAlternative delivery system
ADSC - answerAverage daily service charge
ADT - answerAdmission/discharge/transfer
Advance Beneficiary Notice (ABN) - answerThe mandated form required to be used for
Medicare beneficiaries related to non-covered services. Waiver that a provider has a
patient sign confirming the patient's understanding that certain provided services may
not be reimbursable under Medicare and therefore are the patient's responsibility.
AFDC - answerAid to Families with Dependent Children
AFDS - answerAlternative financing and delivery systems
Affiliation - answerArrangement between organizations by which the named
organizations remain independent but have influence on each other; affiliations may or
may not be permanent and may not result in common ownership or control of the
affiliates.
,After care - answerServices following hospitalization or rehabilitation
Aging - answerProcess wherein accounts receivable or accounts payable are
scheduled; listed; or arranged based on elapsed time from date of service or transaction
AHA - answerAmerican Hospital Association
AHP - answerAllied health professional
AHRQ - answerAgency for Healthcare Research and Quality
Aid to Families with Dependent Children (AFDC) - answerState-based federal cash
assistance program for low-income families
AIDS Drug Assistance Programs (ADAP) - answerJoint federal-state sponsored
programs that assist eligible HIV-positive patients in obtaining HIV medications
ALC - answerAlternate level of care
All inclusive rate - answerCharge rate established by a healthcare provider that covers
all services a beneficiary may receive or be entitled to receive over a designated period
of time
Allied health personnel - answerSpecially trained and licensed health workers other
than physicians; dentists; optometrists; chiropractors; podiatrists; and nurses
Allowable costs - answerCosts incurred by a provider in the course of providing services
that are recognized as eligible for reimbursement by a third-party payer
Allowance for bad debts - answerAn estimate of the amount of accounts receivable that
a healthcare provider will be unable to collect; it reduces the value of accounts
receivable.
Allowed amount - answerMaximum amount Medicare will pay in a given area for a
covered service
ALOS - answerAverage length of stay
Ambulatory care - answerHealth services rendered outside the inpatient setting
Ambulatory patient group (APG); Ambulatory Payment Classification (APC) -
answerInstitutional outpatient reimbursement system based on the methodology
developed by CMS; APCs/APGs are to outpatient visits/services what DRGs are to
inpatient hospital admissions; the payments are based on categories or groupings of
like or similar services requiring like or similar professional services and supply
utilization.
, Ambulatory setting - answerInstitution-based healthcare in which services are provided
in the outpatient setting.
AMCC - answerAutomated multi-channel chemistry
American National Standards Institute (ANSI) - answerParent organization of the ASC
X12 and the recognized coordinator and clearinghouse for information on United States
and Canadian national standards.
Ancillary service - answerThose services other than room; board; and medical and
nursing services; such as laboratory; radiology; pharmacy; and therapy services
ANSI - answerAmerican National Standards Institute
APC - answerAmbulatory payment classification
APG - answerAmbulatory patient group
APHP - answerAcute partial hospitalization program
Appeal - answerRequest by a provider or beneficiary to have coverage and/or payment
determination reconsidered
AR - answerAccounts receivable
AS - answerAdmission scheduling
ASC - answerAdministrative services contract; ambulatory surgical/surgery center
ASF - answerAmbulatory surgical facility
ASO - answerAdministrative services only
Assignment - answerAgreement in which a patient transfers to a provider the right to
receive payment from a third party for the service the patient has received
Attending physician - answerLicensed physician who supervises the care and treatment
of a patient
Attestation - answerPhysician's report attesting to the principal diagnosis; secondary
diagnosis; and names of the major procedures performed; which must be completed
shortly before or shortly after the patient is discharged; signature of authorized
representative affirming that information in a CMS enrollment application is true
AAR - answerAfter-hours activity report
ABN - answerAdvance Beneficiary Notice
ACC - answerAmbulatory care center
Access - answerAbility to receive hospital; physician or other medical services without
regard to an individual's ability to pay
Accounts receivable (A/R) - answerMoney owed to an organization for goods or
services furnished
Accounts receivable (A/R) collection period - answerNumber of days in the accounting
period divided by accounts receivable turnover. This ratio tells you the average time it
takes to collect amounts due.
Accounts receivable (A/R) turnover - answerServices rendered on credit during the
period divided by the A/R balance. This ratio tells you how many times you collect your
AR in a given cycle.
Accreditation - answerFormal process by which an agency or organization evaluates
and recognizes a program as meeting certain predetermined criteria or standards. A
formal process for certifying that providers and health plans meet predetermined
standards.
Accredited Standards Committee X12 (ASC X12) - answerGroup of industry members
that creates electronic data interchange standards for submission to the American
National Standards Institute for subsequent approval and dissemination.
ACS - answerAmbulatory care services
,Acute care - answerHospital care given to patients who generally require a stay up to
seven days and that focuses on a physical or mental condition requiring immediate
intervention and constant medical attention; equipment; and personnel
AD - answerAdmitting diagnosis
ADC - answerAverage daily census
Administrative services only (ASO) - answerContract between an insurance company or
claims administrator and a self-funded plan where the insurance company/claims
administrator performs certain services but does not assume any risk; services usually
include claims processing but may also include such services as group billing; actuarial
analysis; utilization review; and provider network development
Admission - answerFormal registration of a patient who is to be provided with medical
care by the provider
Admitting diagnosis - answerDiagnosis provided on admission; explaining the reason for
admission and coded according to current diagnosis coding conventions
ADP - answerAutomated data processing
ADR - answerAverage daily revenue
ADRG - answerAdjacent diagnosis-related group; alternative diagnosis related group
ADS - answerAlternative delivery system
ADSC - answerAverage daily service charge
ADT - answerAdmission/discharge/transfer
Advance Beneficiary Notice (ABN) - answerThe mandated form required to be used for
Medicare beneficiaries related to non-covered services. Waiver that a provider has a
patient sign confirming the patient's understanding that certain provided services may
not be reimbursable under Medicare and therefore are the patient's responsibility.
AFDC - answerAid to Families with Dependent Children
AFDS - answerAlternative financing and delivery systems
Affiliation - answerArrangement between organizations by which the named
organizations remain independent but have influence on each other; affiliations may or
may not be permanent and may not result in common ownership or control of the
affiliates.
,After care - answerServices following hospitalization or rehabilitation
Aging - answerProcess wherein accounts receivable or accounts payable are
scheduled; listed; or arranged based on elapsed time from date of service or transaction
AHA - answerAmerican Hospital Association
AHP - answerAllied health professional
AHRQ - answerAgency for Healthcare Research and Quality
Aid to Families with Dependent Children (AFDC) - answerState-based federal cash
assistance program for low-income families
AIDS Drug Assistance Programs (ADAP) - answerJoint federal-state sponsored
programs that assist eligible HIV-positive patients in obtaining HIV medications
ALC - answerAlternate level of care
All inclusive rate - answerCharge rate established by a healthcare provider that covers
all services a beneficiary may receive or be entitled to receive over a designated period
of time
Allied health personnel - answerSpecially trained and licensed health workers other
than physicians; dentists; optometrists; chiropractors; podiatrists; and nurses
Allowable costs - answerCosts incurred by a provider in the course of providing services
that are recognized as eligible for reimbursement by a third-party payer
Allowance for bad debts - answerAn estimate of the amount of accounts receivable that
a healthcare provider will be unable to collect; it reduces the value of accounts
receivable.
Allowed amount - answerMaximum amount Medicare will pay in a given area for a
covered service
ALOS - answerAverage length of stay
Ambulatory care - answerHealth services rendered outside the inpatient setting
Ambulatory patient group (APG); Ambulatory Payment Classification (APC) -
answerInstitutional outpatient reimbursement system based on the methodology
developed by CMS; APCs/APGs are to outpatient visits/services what DRGs are to
inpatient hospital admissions; the payments are based on categories or groupings of
like or similar services requiring like or similar professional services and supply
utilization.
, Ambulatory setting - answerInstitution-based healthcare in which services are provided
in the outpatient setting.
AMCC - answerAutomated multi-channel chemistry
American National Standards Institute (ANSI) - answerParent organization of the ASC
X12 and the recognized coordinator and clearinghouse for information on United States
and Canadian national standards.
Ancillary service - answerThose services other than room; board; and medical and
nursing services; such as laboratory; radiology; pharmacy; and therapy services
ANSI - answerAmerican National Standards Institute
APC - answerAmbulatory payment classification
APG - answerAmbulatory patient group
APHP - answerAcute partial hospitalization program
Appeal - answerRequest by a provider or beneficiary to have coverage and/or payment
determination reconsidered
AR - answerAccounts receivable
AS - answerAdmission scheduling
ASC - answerAdministrative services contract; ambulatory surgical/surgery center
ASF - answerAmbulatory surgical facility
ASO - answerAdministrative services only
Assignment - answerAgreement in which a patient transfers to a provider the right to
receive payment from a third party for the service the patient has received
Attending physician - answerLicensed physician who supervises the care and treatment
of a patient
Attestation - answerPhysician's report attesting to the principal diagnosis; secondary
diagnosis; and names of the major procedures performed; which must be completed
shortly before or shortly after the patient is discharged; signature of authorized
representative affirming that information in a CMS enrollment application is true
