Also known as EMT-4 and provides the most extensive prehospital care in an emergency situation. Also see emergency medical technician (EMT) .
Insurance Encyclopedia
Enabling bond
A bond required by insolvency practioners under the Insolvency Practitioners Regulations (minimum £250,000) in respect of the assets to come under their control in respect of each appointment taken and which has to be detailed on monthly bordereaux submitted to the holder’s bond insurer and relevant professional body.
Enabling services
Ancillary services that help patients to access medical care (e.g., shuttle transportation or translator services).
Encoder
Add-on software to practice management systems that can reduce the time it takes to build or review insurance claims before batch transmission to the carrier. It takes codes entered by a coder, and by using a series of built-in prompts it enables him or her to code more accurately and specifically. The encoder bases its code selection on clinical documentation and can generate diagnostic and/or procedural codes. The prompts perform such tasks as resequencing codes by priority, verifying the relationship between grouped codes, and suggesting additional related codes not originally entered by the coder. Two types of encoder systems exist: logic based and dictionary driven.
Encoder dictionary-driven system
Method used in encoder software in which a coder enters a keyword that brings up a menu of either diagnostic or procedural codes from which a coder can choose.
Encoder logic-based system
Method used in encoder software in which a coder enters a keyword that generates a series of prompts or questions that ends with a suggested diagnostic or procedural code.
Encounter
1. Face-to-face meeting and communication of a provider and a patient for the diagnosis and treatment of a disease or injury. This may occur in an office, home, or hospital facility setting. 2. One contact or episode of service to a patient. Also known as a visit .
Encounter (Health Insurance)
A meeting with a health care provider, in which the insured receives any type of service.
Encounter data
Detailed information about individual medical services, regarding how a patient was treated, that are provided to a capitated managed care plan by the provider. The level of detail about each medical service reported is similar to that of a standard insurance claim form. Encounter data are also sometimes referred to as shadow claims .
Encounter fee
Dollar amount that is charged to a managed care plan member by a provider when medical service is provided in a preferred provider hospital emergency department or in the office of the preferred provider. A schedule of benefits or fee schedule in the managed care contract lists the amount of the fee for each type of medical service along with the procedural code.