Term

Definition

Service rules

The rules that determine how encounters are converted into billable services. Configured under Billing → Service Rules.

Services

Claim line items generated from encounters. Found on the Encounters/Services screen in the Billing module.

Encounters

Clinical documentation completed during a patient interaction.

ERA / EOB / remit / 835

All refer to the same thing: the payer's electronic adjudication response to a submitted claim. ERA = Electronic Remittance Advice. EOB = Explanation of Benefits (paper version). 835 = the EDI file format.

Stedi

Ritten's clearinghouse partner. Ritten submits claims to Stedi, which converts them to EDI format and routes them to payers.

PCN

Patient Control Number — generated by Ritten when a claim is submitted.

ICN

Internal Control Number — generated by the payer. Required when resubmitting a corrected claim (Box 22).

Correlation ID

Stedi's unique identifier for a specific claim submission. Include this when contacting Stedi support about a specific claim.

CMS-1500

Professional claim form used for outpatient and IOP services.

UB-04

Institutional claim form used for residential and higher levels of care.

Auth / authorization

Prior approval from a payer agreeing to cover a specified number of units of service over a specified period. Must typically be obtained before services are provided.

UR / Utilization Review

The process of tracking authorization usage. Found at Billing → Utilization Review.

VOB

Verification of Benefits. An eligibility check confirming active insurance coverage, copay, deductible, and out-of-pocket maximum.

AR

Accounts Receivable. Outstanding amounts owed to your organization.

CPT code

Current Procedural Terminology code. Defines the type of service billed. Payers use CPT codes to determine payment.

Revenue code

Used on UB-04 claims alongside the CPT code.

PR code

Patient Responsibility adjustment code. PR codes shift the outstanding balance to the client rather than counting as a write-off.

CO code

Contractual Obligation adjustment code. Represents the payer's contractual reduction — the amount written off per your in-network agreement.

OA code

Other Adjustment code. Miscellaneous write-offs not covered by CO or PR categories.

NPI

National Provider Identifier.

TOB

Type of Bill. UB-04 specific field (Box 4).

POS

Place of Service code. Used on CMS-1500 claims.

NTE segment

Box 19 on CMS-1500, Box 80 on UB-04. A remarks field. Note: this field is not transmitted to payers under standard circumstances, but is required for 42 CFR Part 2 disclosures in Minnesota.

Data Studio

Ritten's AI-powered reporting feature. Allows plain-English queries against your billing and clinical data.

Insights

Ritten's built-in reporting tool. Includes the AR Dashboard, payments and adjustments reports, collection rates, claim balances, and client balances.

Billing Census

A grid view for per-diem and inpatient billing workflows. Use it to review generated services and bulk-create claims.

Billing Chart Completeness

A feature that flags client charts with missing information that would prevent claim submission.

Rule Inspector

A diagnostic tool (magnifying glass icon on the Encounters screen) that shows exactly which service rules matched or didn't match for a given encounter, and why.

IOP

Intensive Outpatient Program.

PHP

Partial Hospitalization Program.

A/D/T

Admit / Discharge / Transfer. Changes to these events automatically trigger service rule reruns.