Payment needed to maintain membership in a professional association.

Insurance application that is completed by the employer for an employee who is temporarily not available. The application is submitted unsigned to the insurance company. The health plan’s group processing division includes this dummy application to verify group eligibility, estimate the enrollment percentage, and verify rates based on final enrollment. If necessary, modifications to the application are made when the employee returns to work.

Messages or phrases to inform or remind a patient about a delinquent account, usually printed on monthly billing statements. They can appear as a handwritten note or a brightly colored adhesive label.

1. Practice of billing for the same medical service more than once. In the Medicare program, a physician who repeatedly submits duplicate claims may be removed from the electronic billing network. 2. Resubmission of identical insurance claims with no changes. Duplicate claims are considered fraudulent. Also called double billing .

Query form completed to an insurance company or medical provider to find out where there is other health insurance coverage under another plan. Such inquiries are made for the purpose of coordination of benefits between the two or more plans.

Insurance coverage of an insured under two or more policies who collects, or may collect, payments for the same hospital, or medical expenses from more than one insurer. Also known as dual coverage, duplication of benefits , or multiple coverage .

1. Billing phrase to Medicare and Medicaid fiscal intermediaries to specify medical supplies, devices, and equipment (e.g., crutches, urinary catheters, ostomy supplies, surgical dressings) for reimbursement. 2. Purchased or rented items such as a walker, seat lift equipment, wheelchairs, a hospital bed, and other medically necessary equipment prescribed by a health care provider to be used in a patient’s home and which are covered by the Medicare program. DME is paid under both Medicare Part B and Part A for home health services. Also called home medical equipment .

Group or individual provider number used when submitting bills for specific medical supplies, devices, and equipment to the Medicare fiscal intermediary for reimbursement.

Four contracted regional carriers (private companies) that contract with Medicare to process and pay insurance claims for durable medical equipment such as orthotics, prosthetics, and supplies. Providers are required to obtain supplier numbers and disclose ownership before submitting claims. Also called contractor and durable medical equipment regional contractor (DMERC) .