Online transaction or electronic summarized statement about the status of an insurance claim with explanation of the payment for one or more beneficiaries. It is equivalent to the paper summarized statement called a Medicare remittance notice (MRN) . It is often referred to as ANSI 835 or Health Care Claim Payment/Advice (835) . Also called electronic remittance notice (ERN) .

Electronic explanation of benefits that is transmitted to the medical practice when an insurance company (payer) transmits an electronic payment that is automatically deposited in the medical practice’s bank account.

Method of authenticating documents by either insertion of a facsimile of a person’s actual handwritten signature, typed name, mark, symbol, or code that is affixed electronically to the end of a document. Electronic signatures are subject to federal and state laws. Some state laws permit their use in place of a pen-and-ink signature. Electronic signatures are not designed to be secure.
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US: An electronic sound, symbol, or process attached to or logically associated with a contract or record and executed or adopted by a person with the intent to sign the record.

Transmission of dental insurance claims for adjudication or eligibility transactions via modem (telephone lines). See electronic claim submission (ECS) .

Communication via electronic mail (e-mail) of a patient with a physician for the purpose of health treatment/care (e.g., medication assessment or laboratory results). Some insurance plans allow some coverage for e-visits. The timeline is that usually an e-mail is answered before the end of the next business day.

1. Number of items necessary for coding an evaluation and management (E/M) service. 2. When an audit is taking place, term used to indicate E/M criteria for documenting services rendered. Also known as a bullet .

1. Qualifying factors that must be met before a patient receives benefits (medical services) under a specified insurance plan, government program, or managed care plan. 2. Refers to the process whereby an individual is determined to be eligible for health care coverage through the Medicaid program. Eligibility is determined by the State. Eligibility data are collected and managed by the State or by its fiscal agent. In some managed care waiver programs, eligibility records are updated by an enrollment broker who assists the individual in choosing a managed care plan in which to enroll.
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UK: Conditions that govern a person’s right of entry into a pension scheme or right to receive a particular benefit. The conditions may relate to age, service, status and type of employment but there must be no discrimination in eligibility on grounds of sex. The Barber judgment applies to all retirement benefits earned after 17 May 1990 and is endorsed by regulations under PA95 for equal treatment between the sexes.

Month, day, and year an individual and/or spouse and dependents become eligible for benefits under an insurance plan or date he or she may apply for insurance.
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The date that a person is eligible for benefits.

In group health insurance, the conditions that an individual must meet to obtain coverage such as age, employment status, and continued employment.