Insurance category composed of individuals whose loss is considered normal or average. This class pays basic or standard premium rates. Other classifications are given credits or debits depending on their difference from the standard.

Association accredited by the American National Standards Institute that develops and maintains standards for information transactions or data elements or any other standard under the Health Insurance Portability and Accountability Act (HIPAA).

Electronic claims transmittal format of the CMS-1500 insurance claim.

An Electronic Healthcare Network Accreditation Commission (EHNAC)-sponsored Washington Publishing Company (WPC)-hosted Health Insurance Portability and Accountability Act (HIPAA) compliance certification service.

1. Under the Health Insurance Portability and Accountability Act (HIPAA), the electronic files in which medical data are compiled to produce a specific format. 2. Under HIPAA, a transaction that complies with the applicable HIPAA standard.

Legislation that is uniform in all states and stipulates the minimum standards for calculating or valuing insurance reserves that a life insurance company must maintain for its life insurance policies and annuity contracts. It was first developed by the National Association of Insurance Commissioners.

Act of making charges or costs more comparable among medical providers, plans, and geographical areas. This is accomplished by adjusting specific services or bundles of services to remove differences that result from geographical variation in prices and beneficiary health risk.

Set of guidelines for medical tests and procedures that are considered covered services for specific predetermined diagnoses.

Code of conduct developed by the American Health Information Management Association to provide a basis for ethical decision-making in coding practice.

Backup anesthetist requested by another physician for a case that involves prolonged attendance without direct patient contact. If the physician does the procedure, this service would not be billable.