Glossary

Glossary and Acronyms
Term Sort descending	Definition
ASSIGNED CLAIM	A claim submitted for a service or supply by a provider who accepts Medicare assignment.
AUTOMATED CLAIM REVIEW	Claim review and determination made using system logic (edits). Automated claim reviews never require the intervention of a human to make a claim determination.
CLAIM	A claim is a request for payment for services and benefits you received. Claims are also called bills for all Part A and Part B services billed through Fiscal Intermediaries. "Claim" is the word used for Part B physician/supplier services billed through the Carrier. (See Carrier; Fiscal Intermediaries; Medicare Part A; Medicare Part B.)
CLAIM ADJUSTMENT REASON CODES	A national administrative code set that identifies the reasons for any differences, or adjustments, between the original provider charge for a claim or service and the payer's payment for it. This code set is used in the X12 835 Claim Payment & Remittance Advice and the X12 837 Claim transactions, and is maintained by the Health Care Code Maintenance Committee.
CLAIM ATTACHMENT	Any of a variety of hardcopy forms or electronic records needed to process a claim in addition to the claim itself.
CLAIM STATUS CATEGORY CODES	A national administrative code set that indicates the general category of the status of health care claims. This code set is used in the X12 277 Claim Status Notification transaction, and is maintained by the Health Care Code Maintenance Committee.
CLAIM STATUS CODES	A national administrative code set that identifies the status of health care claims. This code set is used in the X12N 277 Claim Status Inquiry and Response transaction, and is maintained by the Health Care Code Maintenance Committee.
ELECTRONIC MEDIA CLAIMS	A flat file format used to transmit or transport claims, such as the 192-byte UB-92 Institutional EMC format and the 320-byte Professional EMC NSF.
ELECTRONIC MEDIA CLAIMS	This term usually refers to a flat file format used to transmit or transport claims, such as the 192-byte UB-92 Institutional EMC format and the 320-byte Professional EMC NSF.
HEALTH INSURANCE CLAIMS NUMBER	The number assigned by the Social Security Administration to an individual identifying him/her as a Medicare beneficiary. This number is shown on the beneficiary's insurance card and is used in processing Medicare claims for that beneficiary.