Resources
Medical Billing and RCM Resources
This page collects practical guides, tools and definitions for practice owners, administrators and billing teams.
Guides
Practical guides
Tools & references
Tools and references
Glossary
Revenue cycle terms, defined
| Term | Definition |
|---|---|
| A/R (accounts receivable) | Money owed to the practice for services already provided, from payers or patients. |
| Adjudication | The payer’s process of reviewing a claim and deciding what to pay. |
| CARC | Claim Adjustment Reason Code. It explains why a claim or line was paid differently than billed. |
| RARC | Remittance Advice Remark Code. It adds detail to a CARC. |
| Clean claim | A claim accepted and processed without corrections or requests for more information. |
| Clearinghouse | An intermediary that checks and forwards electronic claims to payers. |
| ERA (835) | Electronic remittance advice: the payer’s electronic explanation of a payment. |
| Eligibility verification | Confirming a patient’s coverage and benefits before the visit. |
| Timely filing limit | The deadline, set by each payer, for submitting a claim. |
| Business Associate Agreement | A HIPAA-required contract between a covered entity and a vendor that handles protected health information on its behalf. |
Let’s take a closer look at your revenue cycle
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