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Health insurance
Industry: Insurance
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Health insurance
co-operating provider
Health care; Managed care
A medical provider who has entered into an agreement to provide health care to plan members.
unique provider identification number (UPIN)
Health care; Managed care
A medical provider’s identification number (issued by CMS) that is used on Medicare claims.
Program All Inclusive for the Elderly (PACE)
Health care; Managed care
A medical, social, and long-term care program for fragile senior citizens, sponsored by various state Medicaid programs to keep them functioning in the community for as long as possible.
expedited appeal
Health care; Managed care
A Medicare + Choice or managed care organization’s second look at whether it will provide a health service. A beneficiary may receive a fast decision within 72 hr when life, health, or ability to ...
dual eligibility
Health care; Managed care
A Medicare beneficiary who also receives the full range of Medicaid benefits offered in his or her state.
provider affiliated contractor
Health care; Managed care
A Medicare carrier, medical professional, or other contractor, such as a durable medical equipment regional carrier (DMERC), which shares some or all of the program safeguard contractor’s (PSC’s) ...
