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
Privacy Act of 1974
Insurance; Medicare & Medicaid
Without the written consent of the individual, the Privacy Act prohibits release of protected information maintained in a system of records unless of 1 of the 12 disclosure provisions applies.
Voluntary agreement
Insurance; Medicare & Medicaid
Agreements between CMS and various insurers and employers to exchange Medicare information and group health plan eligibility information for the purpose of coordinating health benefit payments.
Medical code sets
Insurance; Medicare & Medicaid
Codes that characterise a medical condition or treatment. These code sets are usually maintained by professional societies and public health organizations. Compare to administrative code sets.
Physician services
Insurance; Medicare & Medicaid
Services provided by an individual licenced under state law to practise medicine or osteopathy. Physician services given while in the hospital that appear on the hospital bill are not included.
Monitoring of MCO/PHP standards
Insurance; Medicare & Medicaid
Activities related to the monitoring of standards that have been set for plan structure, operations, and quality improvement/assurance to determine that standards have been established, implemented, ...
Logical observation identifiers, names and codes
Insurance; Medicare & Medicaid
A set of universal names and ID codes that identify laboratory and clinical observations. These codes, which are maintained by the Regenstrief Institute, are expected to be used in the HIPAA claim ...
Health Care Provider Taxonomy Committee
Insurance; Medicare & Medicaid
An organisation administered by the NUCC that is responsible for maintaining the Provider Taxonomy coding scheme used in the X12 transactions. The detailed code maintenance is done in coordination ...
