Administrative Terms, Acronyms, and Billing Standards
Welcome to the Integral Clinic Solutions Medical Practice Management Glossary. Navigating independent healthcare administration requires absolute clarity.
Use this index to find clear, operational definitions for complex provider credentialing acronyms, revenue cycle management (RCM) workflows, and medical billing compliance standards.
- 25 Modifier
- 60-Day Rule
- 837 File
- Accounts Receivable Management
- ADA Compliance
- Admitting Privileges
- AMA CME Training
- Ambulatory Surgery Center (ASC)
- Attribution (Patient Attribution)
- Audio-Only Telehealth
- Audit Trail
- Auth Number
- Authorization Coordinator
- Authorization Number
- Auto-Renewal (Virtual Address Subscriptions)
- Behavioral Health Telehealth
- Bundled Procedures
- Bundled Services
- Bundling
- Business Registration Address
- CAQH (Council for Affordable Quality Healthcare)
- Care Gap
- Cash Flow Forecasting
- Certificate of Completion
- Certificate of Medical Necessity (CMN)
- Chronic Care Management
- Chronic Care Management (CCM)
- Claim Denial Reason
- Claim Lifecycle
- Claim Scrubbing
- Clean Claim
- Clean Claims
- Clearinghouse
- Clinical Quality Measure (CQM)
- CMS-1500 Form
- Community Care Network (CCN)
- Compliance Changes
- Compliance Risk
- Comprehensive Clearinghouse
- Continued Need / Continued Use
- Continuity of Care
- Controlled Substance CME
- Controlled Substances
- Courtesy Privileges
- Coverage Window
- CPT
- CPT Code
- CPT Codes
- CPT Modifier
- CPT Modifier 25
- CPT Modifiers
- Credentialing
- Credentialing Committee
- Credentialing Packet
- Credentialing Process (Military Insurance)
- Credentialing Workflow
- Cross-Training
- Cybersecurity Threats
- DEA 8-Hour Rule
- DEA 8-Hour Training
- DEA CME Requirement
- DEA Education Mandate
- DEA License Renewal
- DEA Opioid Training
- DEA Renewal Checklist
- DEA Training Certificate
- Deductible Season
- Denial Code
- Denial Management
- Diagnosis Code
- Durable Medical Equipment (DME)
- EDI (Electronic Data Interchange)
- EDI Enrollment
- Edit Code
- Edit Rules
- EFT (Electronic Funds Transfer)
- EHR (Electronic Health Record)
- EHR Referral Modules
- Electronic Tracking Systems
- EMR (Electronic Medical Record)
- EMR Tracking Tools
- End-Stage Renal Disease (ESRD) Dialysis Telehealth
- EOB
- EOB Code
- ERA (Electronic Remittance Advice)
- Exclusion Monitoring
- Expiration Date (Drug/Vaccine)
- Explanation of Benefits (EOB)
- Fee-for-Service (FFS)
- Fee Schedule
- Fee Schedule Setup
- Follow-Up Strategy
- Gross Production
- HCPCS Level II Codes
- HCPCS Unit
- Healthcare Reputation Management
- Healthcare Survey Tools
- Health Professional Shortage Area (HPSA)
- HEDIS Measures
- Hidden Fees
- High-Deductible Health Plan (HDHP)
- HIPAA Compliance
- HIPAA‑Compliant
- HIPAA-Compliant Virtual Mailbox
- Hospitalist
- Hospital Privileges
- ICD10
- ICD-10 Codes
- Incentive Payments
- Insurance Credentialing
- Insurance Explanation
- Insurance Policy Rules
- Insurance Verification
- J-Code(s)
- Labeler Code (NDC)
- LCD (Local Coverage Determination)
- Locum Tenens
- Lot Number
- MAT Waiver
- Medical Necessity
- Medicare Final Rule 2026
- Military Insurance
- Modifier 25
- Modifier Q5
- Modifier Q6
- National Provider Identifier (NPI)
- NCCI
- NCCI Edit Rules
- NCQA-Certified CVO
- NDC Unit
- Necessary Service
- Net Collections
- Non-Network Participating Provider
- Non-Participating Provider
- No-Show Rate
- NPI Mismatch
- Online Reputation for Doctors
- Opioid Prescribing Education
- Originating Site
- Overpayment Recovery
- Package Code (NDC)
- Package Handling (Virtual Address Services)
- Panel Management
- PA Number
- Patient Engagement Strategy
- Patient Engagement Tools
- Patient Loyalty
- Patient Portal
- Patient Recall System
- Patient Recall Workflow
- Patient Satisfaction Surveys
- Patient Segmentation
- Patient Volume Surge
- Payer Denial
- Payer Guidelines
- Payor-Specific Rules
- PCSS
- Per Diem Payment
- PHI
- Place of Service (POS) Codes
- Plan-Specific Guidelines
- Portal Adoption
- Portal Metrics
- Practice Management System (PMS)
- Preventive Care Revenue
- Pricing Table
- Primary Source Verification (PSV)
- Prior Authorization
- Proactive Outreach
- Procedure Modifier
- Product Code (NDC)
- PTAN (Provider Transaction Access Number)
- QR Code Surveys
- Real‑Time Eligibility Check
- Real-Time Eligibility Check
- Real-Time Eligibility (RTE)
- Real-Time Monitoring
- Reciprocal Billing
- Referral Coordinator
- Referral End Date
- Referral Expiration
- Referral Expiration
- Referral Limit
- Referral Log
- Referral Management
- Referral Specialist
- Referral Specialist
- Referral Tracking
- Referral Validity
- Rejected Claim
- Rental Caps / Capped Rental
- Retroactive Authorization
- Retro Auth
- Retro Authorization
- Risk Adjustment
- Role-Based Access
- SAMHSA
- Secure Messaging
- Service Expansion
- Service Location Address
- Shared Savings Program
- Staff Onboarding
- State Medical Board CME
- Substance Use Disorder Training
- Surgical Privileges
- System Integration
- Teaching Physician Supervision
- Telehealth Licensing Requirements
- Temporary Privileges
- Text Surveys for Patients
- Third-Party Vendor
- Time Frame (Authorization)
- TPE (Targeted Probe and Educate)
- TRICARE Allowable Rate
- Tricare for Life (TFL)
- Tricare West
- TriWest
- Two-Factor Authentication (2FA)
- Upcoding / Templates (Audit Trigger)
- USPS Form 1583
- Validity Period
- Value-Based Care
- VA Referral Authorization
- Vendor Audit
- Vendor Contract
- Vendor Guarantee
- Vendor Operational Risk
- Vendor Red Flag
- VFC (Vaccines for Children)
- Virtual Business Address
- Visit Cap
- Visit Limit
- Word-of-Mouth Marketing in Healthcare
- X DEA Designation