Health Care Systems
Facilities include rehab centers, outpatient surgery centers, and physician offices.
What are ambulatory care centers?
This government agency monitors and prevents disease outbreaks, including bioterrorism.
What is the Center for Disease Control and Prevention (CDC)?
This has contributed to the rising costs of health care, where alleged victims get a cash-based settlement.
What are health-related lawsuits?
This is the payer that trumps Medicare B outpatient therapy. If a patient has an open episode from this insurer they can not receive outpatient rehab services.
What is an open Medicare A (inpatient) episode?
This plan covers former employees for a time period of up to 18 months after he or she leaves their job.
What are COBRA benefits?
These services include providing education materials, water and food purity, alcohol and drug abuse control, and maternal health.
What are public health services?
This is the world's leading agency for conducting and supporting medical research.
What is the National Institute of Health?
This health plan requires the member to get medical care from physicians, labs, and hospitals that agree to the fee that the insurance organization is willing to pay.
What are Health Maintenance Organizations?
These are payments and assistance based on an agreement.
What are benefits?
This insurance plan provides coverage to military personnel and their families.
What is Tricare?
This is an official chain that provides a problem-solving structure and helps to ensure communication among relevant parties.
What is a chain of command?
This is the medical specialty concerned with correcting problems with the skeletal system.
What is orthopedics?
Michele has an 8400 surgery on her ankle and is required to pay a 20% co-insurance. This is the amount in which she must pay.
What is $1,680?
The ACA made these services available to members without copay, coinsurance, or deductibles.
What are Annual Wellness/Prevention Checkups?
This plan is funded jointly by state and federal dollars but is ran at the state level.
What is Medicaid?
What are the departments that fall under therapeutic services?
These facilities were designed to provide care for those who require constant nursing care and have significant problems with activities of daily living.
What are Extended Care Facilities?
This insurance plan cares for workers who are injured while on duty at work.
What is Worker's Compensation Insurance?
This is a number or letter combination that is 4 or 5 digits that represents the reason why a provider might provide a certain treatment.
What are ICD-10 Codes?
This plan provides services for anyone eligible for Social Security and covers hospital services.
What is Medicare A Coverage?
This facility generally engages in geriatric care.
What are Nursing Homes (or convalescent care facilities)?
These are the grouping of medical conditions which were approved by legislation in 1983.
What are Diagnostic-Related Groups (DRGs)?
This health plan covers a person who is blind, disabled, or has several medical conditions, such as End Stage Renal Disease.
What is Medicare?
Outpatient services or procedures are billed using these numbers which represent services rendered.
What are CPT codes?
This amount represents the difference between the Fee Schedule and the Allowable charges, usually resulting from a provider signing a preferred provider agreement.
What is a contractual adjustment?