5 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
private fee-for-service service area
Insurance; Medicare & Medicaid
The area where a Medicare Private Fee-for-Service plan accepts members.
outcome
Insurance; Medicare & Medicaid
The result of performance (or nonperformance) of a function or process.
segment
Insurance; Medicare & Medicaid
Under HIPAA, this is a group of related data elements in a transaction.
potential fraud case
Insurance; Medicare & Medicaid
A case developed after the PSC has substantiated an allegation of fraud.
Association for Electronic Health Care Transactions
Insurance; Medicare & Medicaid
An organization that promotes the use of EDI in the health care industry.
staff assisted dialysis
Insurance; Medicare & Medicaid
Dialysis performed by the staff of the renal dialysis center or facility.
grievances and complaints
Insurance; Medicare & Medicaid
Information about grievances and complaints submitted to the health plan.
