Individual who completes and transmits insurance claim forms for professional services rendered to a patient by a health care provider or supplier to insurance carriers and/or fiscal agents for private, state, or federal programs.

1. To send a statement for medical services rendered to the patient. 2. In Medicare fraud, to bill for services or supplies that were not provided. This includes billing for “no shows” (i.e., billing for a service not actually furnished because a patient failed to keep an appointment).

Patient’s or third-party payer’s location (street, city, state, and zip code) to which a billing statement is sent.

Automated functions that address the procedures and processes of billing and accounts receivable.

Individual designated to an insured group who handles collection of charges and subscriber correspondence and other clerical and administrative tasks.

In the Medicare program, the amount the physician can bill for a procedure and the maximum amount he or she can collect from the patient when the claim is taken unassigned. Formerly known as maximum allowable actual charge (MAAC) . See limiting charge .

Administrator or supervisor of the medical billing and collections department, which may or may not include diagnostic and procedural coding.

Provider (physician, clinic, group) who submits an insurance claim for reimbursement for services rendered to a patient.

Company that charges a fee for billing patients, collecting on accounts, and submitting insurance claims to insurance plans for physicians and/or suppliers.