Glossary
A comprehensive list of healthcare and RCM terms
to help you navigate revenue cycle management.
A
Accounts Receivable (A/R)
Adjudication
Adjustment
Advance Beneficiary Notice (ABN)
AI Clinical Documentation Integrity (CDI)
AI Medical Coding
AI Prior Authorization
AI RCM (Revenue Cycle Management)
AI-Centric KPIs
Amount Not Covered
Appeal
Applied to Deductible (ATD)
Assignment of Benefits (AOB)
Attribution
C
Case Mix
Case Rate Reimbursement
Case-Mix Group (CMG)
Cash Flow
Charge Capture
Charge Code
Charge Description Master (CDM)
Charge Status Indicator
Chief Financial Officer (CFO)
Claim
Claim Adjustment
Claim Denial
Claim Rejection
Claim Submission
Claims Processing
Clean Claim
Clearinghouse
Clinical Documentation Integrity (CDI)
Coding
Coding Compliance Plan
Coding Management
Coinsurance
Collections
Compliance
Computer-Aided Diagnosis (CAD)
Conversion Factor (CF)
Copayment
Cost to Collect
Covered Service
CPT Codes
D
Days Sales Outstanding (DSO)
Deductible
Denial Overturned
Denials Management
Diagnosis-Related Group (DRG) Codes
Discharged Not Final Billed (DNFB)
Down-Coding
E
Electronic Data Interchange (EDI) 835
Electronic Funds Transfer (EFT)
Electronic Remittance Advice (ERA)
Eligibility Verification
Encoder
Explanation of Benefits (EOB)
H
Health Information Exchange (HIE)
Health Insurance Portability and Accountability Act (HIPAA)
Healthcare Common Procedure Coding System (HCPCS)
Healthcare Finance Management
Healthcare Operations Management
Healthcare Price Transparency
Healthcare Revenue Cycle
M
Medical Billing
Medical Billing Software
Medical Payment Data
Medicare Code Editor (MCE)
Medicare Summary Notice (MSN)
P
Patient Centered Care
Patient Collections
Patient Engagement
Patient Payment Plans
Patient Responsibility
Patient Statement
Payer Mix
Payer or Payor
Payment Posting
Point-of-Service (POS) Collections
Predictive Analytics
Prior Authorization
Frequently Asked Questions
Revenue Cycle Management is the set of financial processes that begins when a patient schedules an appointment and ends when the balance is resolved through insurance payments, contractual adjustments, write offs, or patient payments. The goal is to secure accurate and timely reimbursement for care by optimizing every financial step the organization takes.