Medicare & Medicaid

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

Capitation

Insurance; Medicare & Medicaid

A specified amount of money paid to a health plan or doctor. This is used to cover the cost of a health plan member's health care services for a certain length of time.

Payer

Insurance; Medicare & Medicaid

In health care, an entity that assumes the risk of paying for medical treatments. This can be an uninsured patient, a self-insured employer, a health plan, or an HMO.

Capped rental item

Insurance; Medicare & Medicaid

Durable medical equipment (like nebulizers or manual wheelchairs) that costs more than $150, and the supplier rents it to people with Medicare more than 25 percent of the time.

Joint Commission on Accreditation of Healthcare organisations

Insurance; Medicare & Medicaid

An organisation that accredits healthcare organizations. In the future, the JCAHO may play a role in certifying these organizations' compliance with the HIPAA A/S requirements.

Certificate of indebtedness

Insurance; Medicare & Medicaid

A short-term certificate of ownership (12 months or less) of a specified portion of a debt due by the federal government to individual holders, bearing a fixed rate of interest.

Electronic media claims

Insurance; Medicare & Medicaid

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.

Long-term care ombudsman

Insurance; Medicare & Medicaid

An advocate (supporter) for nursing home and assisted living facility residents who works to resolve problems between residents and nursing homes or assisted living facilities.