Medical Billing Glossary
Comprehensive definitions and explanations of 50+ key medical billing terms — prior authorization, claim denials, CARC codes, modifiers, bundling, adjudication, and more. Written for billers, practice managers, and RCM teams.
- Add-On Code
- Adjudication
- Affiliation
- Age Verification
- Claim Appeal Process
- Authorization Number
- Authorization Penalty
- Balance Billing
- Billing Code Audits
- Bundled Code
- Bundling
- CARC Code
- Case Management
- Clean Claim
- Claim Adjustment
- Claim Denial
- Claim Edits
- Claim Status
- Concurrent Review
- Coordination of Benefits (COB)
- Copay vs Coinsurance
- CPT Code
- CPT Modifier
- Provider Credentialing
- Deductible
- Dependent Coverage
- Downcoding
- Drug Formulary
- Durable Medical Equipment (DME)
- ER Code
- Explanation of Benefits (EOB)
- Fee Schedule
- ICD-10 Code
- In-Network Provider
- Medical Necessity
- Medical Referral
- Modifier Bundle
- Non-Covered Service
- Out-of-Network Provider
- Out-of-Pocket Maximum
- Precertification
- Prior Authorization
- Provider Contract
- Provider Panel
- Remittance Advice
- Remark Code (RARC)
- Retrospective Review
- Retroactive Denial
- Surprise Billing
- Termination of Coverage
- Timely Filing
- Utilization Review
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This reference is for informational purposes. Always verify against current payer policies and CMS guidelines. Last updated: 2026-04-06.