- Branża: Government
- Number of terms: 15199
- Number of blossaries: 0
- Company Profile:
The federal agency that runs the Medicare program. In addition, CMS works with the States to run the Medicaid program. CMS works to make sure that the beneficiaries in these programs are able to get high quality health care.
A Medicare program that gives you more choices among health plans. Everyone who has Medicare Parts A and B is eligible, except those who have End-Stage Renal Disease.
Industry:Insurance
A publicly available, Internet-based real-time query database that displays publicly available health care provider data from the NPPES in response to a user?s query.
Industry:Insurance
In health care, an entity that assumes the risk of paying for medical treatments. This can be an uninsured patient, a self-insured employer, a health plan, or an HMO.
Industry:Insurance
Management systems and policies for reasonably documenting, monitoring, and correcting operational processes to prevent and detect waste and to ensure proper payment.
Industry:Insurance
Reviews performed on-site at the MCO/PHP health care delivery system sites to assess the physical resources and operational practices in place to deliver health care.
Industry:Insurance
The process of matching one set of data elements or individual code values to their closest equivalents in another set of them. This is sometimes called a cross-walk.
Industry:Insurance
A form that is required for access to Leg 1 (Enrollment Database (EDB)) and, Leg 2 (Medicare Provider Analysis and Review(MEDPAR)) of the Data Support Access Facility.
Industry:Insurance
The clinical and statistical analysis of data sets. Frequently used ESRD data sets include the PMMIS, USRDS, the core indicators, Network files, or CMS analytic files.
Industry:Insurance
A measure of the adequacy of the financing as determined by the difference between assets and liabilities at the end of the periods for which financing was established.
Industry:Insurance
A specified amount of money paid to a health plan or doctor. This is used to cover the cost of a health plan member's health care services for a certain length of time.
Industry:Insurance
