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15 Cards in this Set
- Front
- Back
- 3rd side (hint)
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COPAY
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Copay: Provision requiring policyholder to pay to a provider for each visit or service received.
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Payment specific dollar amount; provider; per service
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COINSURANCE
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Coinsurance: Percentage paid for covered services after deductible and the copayment paid.
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Percentage paid after deductible and copayment paid.
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CMS-1500
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CMS-1500: Form used to submit Medicare claims; previously called the HCFA-1500
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FEE SCHEDULE
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List of predetermined payments for health care services provided to patients (e.g. a fee is assigned to each CPT code)
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HCFA-1500
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Now called the CMS-1500. Please see the definition for CMS-1500.
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HEALTH CARE
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Illnesses, injuries and medical concerns, but also include preventative services.
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medical care plus preventative care
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MEDICAL CARE
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Identification of diseases, provision of care & treatment as provided by health providers to those who are sick, injured, or concerned health status.
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Injured, sick and health concerns.
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LIEN
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The right to take and hold or sell the property of a debtor as security or payment for a debt or duty.
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Take and hold to settle outstanding debt matters.
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SUBROGATION
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The substitution of one person for another, especially the legal doctrine of substituting one creditor for another.
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MINIMUM DATA SET
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Data elements collected by long-term care facilities.
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HEALTH MAINTENANCE ORGANIZATION
(HMO) |
Responsible for providing health care services to subscribers in a given geographical area for a fixed fee.
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BASE PERIOD
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Period of time that usually covers 12 months and is divided into 4 consecutive quarters.
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Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
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CHAMPVA: Healthcare benefits for dependents of veterans:
A) rated as 100% permanently and totally disabled due to service-related conditions B) veterans who died in service-related conditions C) and veterans who died on duty with less than 30 days of active service. |
Dependent of veterans what:
100% disabled, died from service-related conditions, or died with less than 30 days of active service. |
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Civilian Health and Medical Program - Uniformed Services
(CHAMPUS) |
CHAMPUS:
A) Now known as TRICARE. B) Benefits for dependents of those serving in armed forces and uniformed branches of the Public Health Service and the National Oceanic and Atmospheric Administration |
Benefits for those serving in {armed and uniformed} forces and Public Health Service AND/OR National Oceanic and Atmospheric Administration
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DEDUCTIBLE
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Amount for which the patient is financially responsible before an insurance agency provides coverage.
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