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Second opinion: When another health care provider gives his or her view about what is wrong with a patient and how it should be treated.

Secondary health insurance plan: There are instances (specifically with Medicare) when the patient will have a second, or "backup," insurance policy that pays all or part of the charges that the primary plan does not cover or is not paid due to a deductible and/or coinsurance.

Secondary payer: An insurance policy, plan, or program that pays benefits after the primary insurer has paid its share of the claim. This could be Medicare, Medicaid, or other health insurance, depending on the situation.

Self-insured: An individual or organization that assumes the financial risk of paying for health care.

Service: Medical care and items such as medical diagnosis and treatment, drugs and biologicals, supplies, appliances, and equipment, medical social services, and use of hospital facilities.

Signature On file (SOF): A term that may be used in Block 12 of the CMS-1500 if the patient has signed a document that says, "I authorize (name of family practice) to release information from my medical record in order to complete this claim form," or words to that effect. This is referred to as a "Release of information" (ROI). Most ROIs are only valid for one year, and caution must be made to always keep an updated ROI in the patient's file.

Social Security Act: Public Law 74-271, enacted on August 14, 1935, with subsequent amendments. The Social Security Act consists of 20 titles, four of which have been repealed. The HI and SMI programs are authorized by Title XVIII of the Social Security Act.

Social Security Administration (SSA): The Federal agency that, among other things, determines initial entitlement to and eligibility for Medicare benefits.

Sole proprietorship: A medical practice or business that is owned and operated by a single individual.

Specialist: A doctor who treats only certain parts of the body, certain health problems, or certain age groups. For example, some doctors treat only heart problems.

Standard claims processing system: Certain computer systems currently used by carriers and FIs to process Medicare claims. For physician and lab claims, the system is Electronic Data Systems (EDS); for facility and other Part A provider claims, the system is the Fiscal Intermediary Standard System (FISS), formerly known as the Florida Shared System (FSS); and for supplier claims, the system is the Viable Information Processing System (VIPS).

Subrogation: One's insurance company will pay a claim, then the legal staff for that particular insurance carrier will go after whoever they feel is responsible for paying the claim. Subrogation is more common with automobile policies where if an individual suffers losses (either material or personal), his or her insurance carrier might go ahead and pay the claim, and then turn around and take the other person's insurance company to court, if they feel the other person was at fault.

Superbill: A "practice-specific" form that lists many of the more common procedures that take place within that specialty and other pertinent information necessary for billing and claims processing. It also indicates the diagnosis and when and if the patient is to return for follow-up care. (See also: Encounter form.)

Symptoms: Signs (such as rash, discoloration, unusual discharge) and feelings (chills, fever, pain) that there is some kind of a process going on with the body that may not be normal.