20 Terms
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Medicare & Medicaid
Medical insurance programs administered by the U.S. federal government that provide health care coverage for the elderly (people over 65) and certain people and families with low incomes and resources.
Industry: Insurance
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Medicare & Medicaid
SEER - Medicare database
Insurance; Medicare & Medicaid
Consists of a linkage of the clinical data collected by the SEER registries with claims for health services collected by Medicare for its beneficiaries.
Anaesthesia
Insurance; Medicare & Medicaid
Drugs that a person is given before surgery so he or she will not feel pain. anaesthesia should always be given by a doctor or a specially trained nurse.
Full capitation
Insurance; Medicare & Medicaid
The plan or Primary Care Case Manager is paid for providing services to enrollees through a combination of capitation and fee for service reimbursements.
Actual charge
Insurance; Medicare & Medicaid
The amount of money a doctor or supplier charges for a certain medical service or supply. This amount is often more than the amount Medicare approves.
Group health plan
Insurance; Medicare & Medicaid
A health plan that provides health coverage to employees, former employees, and their families, and is supported by an employer or employee organization.
Gapfilling
Insurance; Medicare & Medicaid
Used when no comparable, existing test is available. Carrier specific amounts are used to establish a national limitation amount for the following year.
Specialist
Insurance; Medicare & Medicaid
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.
