CRCR
AAR - answerAfter-hours activity report
ABN - answerAdvanced Beneficiary Notice
ACC - answerambulatory care center
Access - answerThe ability to receive hospital, physician or other medical services
without regard to an individuals ability to pay.
Accountable Care Organization (ACO) - answerA coordinated group of healthcare
providers (including physicians, hospitals, and other types of providers) organized to
improve quality and lower the cost of care to a defined group of patients.
Accounting Identity - answerAlso known as the accounting equation; assets = liabilities
+ equity.
Accounts Payable - answerA current liability where funds are owed to suppliers.
Accounts Payable Distribution - answerAn account computer system report that details
the amounts paid to vendors by date, purchase order, and expense classification.
Accounts receivable (A/R) - answerMoney owed to an organization for goods or
services furnished.
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.
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.
Accounts Receivable Aging - answerA report that summarizes accounts receivable from
different sources (such as Medicare or commercial insurance) by thirty day increments.
,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) - answerA committee of the American
National Standards Institute (ANSI) responsible for the development and maintenance
of electronic data interchange (EDI) standards for many industries. The ASC 'X12N' is
the subcommittee of ASC X12 responsible for the EDI health insurance administrative
transactions such as 837 Institutional Health Care Claim and 835 Professional Health
Care Claim forms
Accrual - answerAn expense or a revenue that occurs before the business pays or
receives cash. An accrual is the opposite of a deferral.
Accrual Basis Accounting - answerThe method of accounting that recognizes revenue
when it is earned and matches expenses to the revenues they helped produce
Accrued Payroll and Benefits - answerAn estimate of salaries and associated benefit
costs (such as payroll tax matching) earned by employees but not yet paid by the
employer.
Accumilated Depreciation - answerA balance sheet account where the total amount of
depreciation recognized as expense over time is compiled.
ACS - answerAmbulatory Care Services
Activity Based Costing - answerA technique to assign product costs based on links
between activities that drive costs and the production of specific products.
acuity - answerA measure of the severity of an illness or the resources required to treat
an illness or injury.
acute care hospital - answerA hospital where patients are treated for brief but severe
episodes of illness, injury, trauma, or during recovery from surgery. Patients who require
a stay up to 7 days and that focus on physical or mental condition requiring immediate
intervention and constant medical attention, equipment, and personnel.
AD - answeradmitting diagnosis
Administrative cost - answerIn a health plan, those expenses not paid for medical costs
on behalf of plan members; but instead associated with administrative functions such as
sales, customer services, claims processing, and finance.
Administrative Load Ratio - answerIn a health plan, the percentage of total premiums
collected expended for administrative costs.
,Administrative services only (ASO) - answerContract where a third-party administrator
or insurer provides administrative services to an employer for a fixed fee per employee.
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 - answerThe patient's condition determined by a physician at
admission to an inpatient facility 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) - answerDocument that acknowledges patient
responsibility for payment if Medicare denies the claim.
Advanced Practice Provider (APP) - answerClinical nurse specialists (CNS), nurse
practitioners (NPs) and Physician Assistants (PAs).
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 my 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) - answerFederal funds for children in
families that fall below state standards of need. In 1996, Congress abolished AFDC, the
largest federal cash transfer program, and replaced it with the Temporary Assistance for
Needy Families (TANF) block grant
AIDS Drug Assistance Programs (ADAP) - answerJoint federal-state sponsored
programs that assist eligible HIV-positive patients that assist eligible HIV-positive
patients in obtaining HIV medications.
ALC - answeralternate level of care
All inclusive rate - answera fixed amount charged on a daily basis during a patient's
hospitalization or a total rate charged for an entire stay
allied health professionals - answerHealthcare professionals who support the work of
physicians and perform specific services ordered by the physician. Allied health
professionals include nurses, technologists, technicians, therapists, dentists,
optometrists, chiropractors, podiatrists, and others.
Allowable Costs - answerCosts that are allowed under the terms of the contract.
Typically, allowable costs become relevant under certain types of cost-reimbursable
contracts where the buyer reimburses the seller's allowable costs. If there are non-
allowable costs in a contract, the buyer is not obligated to reimburse the seller for these.
allowance for bad debts - answerA contra asset account, related to accounts receivable,
that holds the estimated amount of uncollectible accounts.
Allowed amount - answerThe maximum amount Medicare will pay for any given area for
a covered service.
ambulatory care - answerServices that do not require an overnight hospital stay.
Services rendered outside the impatient setting.
Ambulatory Patient Groups (APGs) - 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.
AAR - answerAfter-hours activity report
ABN - answerAdvanced Beneficiary Notice
ACC - answerambulatory care center
Access - answerThe ability to receive hospital, physician or other medical services
without regard to an individuals ability to pay.
Accountable Care Organization (ACO) - answerA coordinated group of healthcare
providers (including physicians, hospitals, and other types of providers) organized to
improve quality and lower the cost of care to a defined group of patients.
Accounting Identity - answerAlso known as the accounting equation; assets = liabilities
+ equity.
Accounts Payable - answerA current liability where funds are owed to suppliers.
Accounts Payable Distribution - answerAn account computer system report that details
the amounts paid to vendors by date, purchase order, and expense classification.
Accounts receivable (A/R) - answerMoney owed to an organization for goods or
services furnished.
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.
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.
Accounts Receivable Aging - answerA report that summarizes accounts receivable from
different sources (such as Medicare or commercial insurance) by thirty day increments.
,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) - answerA committee of the American
National Standards Institute (ANSI) responsible for the development and maintenance
of electronic data interchange (EDI) standards for many industries. The ASC 'X12N' is
the subcommittee of ASC X12 responsible for the EDI health insurance administrative
transactions such as 837 Institutional Health Care Claim and 835 Professional Health
Care Claim forms
Accrual - answerAn expense or a revenue that occurs before the business pays or
receives cash. An accrual is the opposite of a deferral.
Accrual Basis Accounting - answerThe method of accounting that recognizes revenue
when it is earned and matches expenses to the revenues they helped produce
Accrued Payroll and Benefits - answerAn estimate of salaries and associated benefit
costs (such as payroll tax matching) earned by employees but not yet paid by the
employer.
Accumilated Depreciation - answerA balance sheet account where the total amount of
depreciation recognized as expense over time is compiled.
ACS - answerAmbulatory Care Services
Activity Based Costing - answerA technique to assign product costs based on links
between activities that drive costs and the production of specific products.
acuity - answerA measure of the severity of an illness or the resources required to treat
an illness or injury.
acute care hospital - answerA hospital where patients are treated for brief but severe
episodes of illness, injury, trauma, or during recovery from surgery. Patients who require
a stay up to 7 days and that focus on physical or mental condition requiring immediate
intervention and constant medical attention, equipment, and personnel.
AD - answeradmitting diagnosis
Administrative cost - answerIn a health plan, those expenses not paid for medical costs
on behalf of plan members; but instead associated with administrative functions such as
sales, customer services, claims processing, and finance.
Administrative Load Ratio - answerIn a health plan, the percentage of total premiums
collected expended for administrative costs.
,Administrative services only (ASO) - answerContract where a third-party administrator
or insurer provides administrative services to an employer for a fixed fee per employee.
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 - answerThe patient's condition determined by a physician at
admission to an inpatient facility 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) - answerDocument that acknowledges patient
responsibility for payment if Medicare denies the claim.
Advanced Practice Provider (APP) - answerClinical nurse specialists (CNS), nurse
practitioners (NPs) and Physician Assistants (PAs).
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 my 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) - answerFederal funds for children in
families that fall below state standards of need. In 1996, Congress abolished AFDC, the
largest federal cash transfer program, and replaced it with the Temporary Assistance for
Needy Families (TANF) block grant
AIDS Drug Assistance Programs (ADAP) - answerJoint federal-state sponsored
programs that assist eligible HIV-positive patients that assist eligible HIV-positive
patients in obtaining HIV medications.
ALC - answeralternate level of care
All inclusive rate - answera fixed amount charged on a daily basis during a patient's
hospitalization or a total rate charged for an entire stay
allied health professionals - answerHealthcare professionals who support the work of
physicians and perform specific services ordered by the physician. Allied health
professionals include nurses, technologists, technicians, therapists, dentists,
optometrists, chiropractors, podiatrists, and others.
Allowable Costs - answerCosts that are allowed under the terms of the contract.
Typically, allowable costs become relevant under certain types of cost-reimbursable
contracts where the buyer reimburses the seller's allowable costs. If there are non-
allowable costs in a contract, the buyer is not obligated to reimburse the seller for these.
allowance for bad debts - answerA contra asset account, related to accounts receivable,
that holds the estimated amount of uncollectible accounts.
Allowed amount - answerThe maximum amount Medicare will pay for any given area for
a covered service.
ambulatory care - answerServices that do not require an overnight hospital stay.
Services rendered outside the impatient setting.
Ambulatory Patient Groups (APGs) - 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.
