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

service area

Insurance; Medicare & Medicaid

The area where a health plan accepts members. For plans that require you to use their doctors and hospitals, it is also the area where services are provided. The plan may disenroll you if you move ...

attending physician

Insurance; Medicare & Medicaid

Number of the licensed physician who would normally be expected to certify and recertify the medical necessity of the number of services rendered and/or who has primary responsibility for the ...

offset

Insurance; Medicare & Medicaid

The recovery by Medicare of a non-Medicare debt by reducing present or future Medicare payments and applying the amount withheld to the indebtedness. (Examples are Public Health Service debts or ...

comprehensive outpatient rehabilitation facility

Insurance; Medicare & Medicaid

A facility that provides comprehensive rehabilitation services under the supervision of a physician to outpatients with physical disabilities. Services include physical therapy, occupational therapy, ...

renal transplant center

Insurance; Medicare & Medicaid

A hospital unit that is approved to furnish transplantation and other medical and surgical specialty services directly for the care of ESRD transplant patients, including inpatient dialysis furnished ...

supplemental edit software

Insurance; Medicare & Medicaid

A system, outside the Standard Claims Processing System, which allows further automation of claim reviews. It may be designed using the logic, or "expertise" of a medical professional. Appendix P, ...

Blue Cross and Blue Shield Association

Insurance; Medicare & Medicaid

An association that represents the common interests of Blue Cross and Blue Shield health plans. The BCBSA serves as the administrator for the Health Care Code Maintenance Committee and also helps ...