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
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Medicare & Medicaid
claim status category codes
Insurance; Medicare & Medicaid
A national administrative code set that indicates the general category of the status of health care claims. This code set is used in the X12 277 Claim Status Notification transaction, and is ...
managed care
Insurance; Medicare & Medicaid
Includes Health Maintenance Organizations (HMO), Competitive Medical Plans (CMP), and other plans that provide health services on a prepayment basis, which is based either on cost or risk, depending ...
independent laboratory
Insurance; Medicare & Medicaid
A freestanding clinical laboratory meeting conditions for participation in the Medicare program and billing through a carrier. A laboratory certified to perform diagnostic and/or clinical tests ...
Medicaid
Insurance; Medicare & Medicaid
A joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid programs vary from state to state, but most health care costs are ...
stochastic model
Insurance; Medicare & Medicaid
An analysis involving a random variable. For example, a stochastic model may include a frequency distribution for one assumption. From the frequency distribution, possible outcomes for the assumption ...
hospital insurance (Part A)
Insurance; Medicare & Medicaid
The Medicare program that covers specified inpatient hospital services, posthospital skilled nursing care, home health services, and hospice care for aged and disabled individuals who meet the ...
notice of proposed rulemaking
Insurance; Medicare & Medicaid
A document that describes and explains regulations that the Federal Government proposes to adopt at some future date, and invites interested parties to submit comments related to them. These comments ...
