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
Add a new termContributors in Medicare & Medicaid
Medicare & Medicaid
Medicare durable medical equipment regional carrier
Insurance; Medicare & Medicaid
A Medicare contractor responsible for administering Durable Medical Equipment (DME) benefits for a region.
Adjusted community rating (ACR)
Insurance; Medicare & Medicaid
How premium rates are decided based on members' use of benefits and not their individual use of benefits.
Reject status
Insurance; Medicare & Medicaid
The encounter data did not pass the "front-end" edit process. M+CO needs to correct the data and resubmit.
Licenced
Insurance; Medicare & Medicaid
This means a long-term care facility has met certain standards set by a State or local government agency.
Basic benefits
Insurance; Medicare & Medicaid
Basic Benefits includes both Medicare-covered benefits (except hospice services) and additional benefits.
Home
Insurance; Medicare & Medicaid
Location, other than a hospital or other facility, where the patient receives care in a private residence.
Non-federal agency
Insurance; Medicare & Medicaid
A State or local government agency that receives records contained in a system of records from a Federal agency to be used in a matching program.
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