A
It is a national program that enables members of one BCBS Plan to obtain healthcare services while traveling or living in another BCBS Plan's service area.
Blue card
Medicare Part that covers Inpatient Services
Medicare Part A
This facility provides preventative, supportive, rehabilitative or therapeutic care is provided to a patient at home.
Home Health
A type of Commercial insurance that covers in and out of network provider and does not require PCP referral
PPO
Medical code to identify a specific illness or disease
ICD-10 or Diagnosis code
It is currently the world’s largest health insurance program. It caters to people who are 65 yrs or older, with disabilities or ESRD
Medicare
It usually refers to the plan that is taken by the patient in his/her state where the patient resides & pays premium.
Home Plan
Medicare Part also known as Medicare Advantage Plan
Medicare Part C
What is Timely Filing Limit for Medicare
1 year from the date of service
It is an insurance that can pay or cover injuries to others and damage to other’s property resulting from an accident an individual cause.
Auto Liability Insurance
It is an individual or institution which is licensed by the federal government to provide healthcare services
Provider
What are the 2 types of Hospital
Acute Care and Chronic Care
A type of Commercial Plan that covers in-network providers and requires PCP referral
HMO
A type of facility that caters to surgery that does not require an overnight stay
Ambulatory Surgery Centers
It is a form of insurance providing wage replacement and medical benefits to employees injured in the course of employment i
Worker's Compensation
What are the 2 Types of Patient
New Patient and Established Patient
It usually refers to the plan/ state in which the patient takes treatment besides his/her Home plan.
Local Plan
A type of facility for terminally ill patients with a life expectancy of not more than 6 months
Hospice
A type of Federal insurance for people below poverty line and no source of income
Medicaid
It is the maximum time limit given by an insurance starting from the Date of first denial, to a provider to submit an appeal on claims denied for various reasons
Appeal limit
What are the two types of Providers
Institutional/ Non Institutional
Individual or Facility
Medicare Part also knows as Medical Insurance. It covers Outpatient services
Medicare Part B
Medicare Part that covers Prescription Drug
Medicare Part D
It is a way for someone with Medicare to qualify for Medicaid, even if their income is higher than the state's Medicaid limit.
Spend down
Medical code for a specific services or procedure
Procedure code or CPT codes