Medical Acronyms Flashcards
Comprehensive law that, among other health insurance reforms, extends health insurance to most of the uninsured (e.g., provides access to health insurance for those with preexisting conditions) and includes rehabilitation and habilitation as health insurance benefits. Various sections of the law have been put into effect while others will be introduced through 2015
PPACA (Preferred Protection and Affordable Care Act)
A Medicare provider type described in the affordable care act. It will be a network of physician group practices or hospital responsible for providing care to patients. This agrees to manage the health care needs of a minimum of 5,000 Medicare beneficiaries for at least three years.
ACO (Accountable Care Organization)
The federal agency that administers the Medicare and Medicaid programs’ aspects not regulated by the states. It was known as the Health Care Financing Administration (HCFA) until June 14, 2001
CMS (Centers for Medicare and Medicaid Services)
A Medicare provider type that includes coverage for a number of outpatient rehabilitation services, including SLP, OT, PT, psychology, and medicine
CORF (Comprehensive Outpatient Rehabilitation Facility)
A listing of codes and corresponding medical procedures published and maintained by the American Medical Association and used by third-party payers for establishing reimbursement rates.
CPT (Common Procedural Terminology)
Both the CPT Editorial Panel and the AMA/Specialty Society RVS Update Committee (RUC) include this composed of representatives from health care professional associations other than those for physicians. The RUC _____ serves as a review board for reviewing survey data that will determine relative professional work values for providers such as SLP and AUD
HCPAC (Health Care Professionals Advisory Committee)
The federal government’s listing of procedures that incorporates the CPT codes at Level I, codes for devices and durable medical equipment and some procedures used by Medicare and Medicaid not found in the CPT list at Level II.
HCPCS (Healthcare Common Procedural Coding System)
A statute that established requirements for employee mobility without loss of insurance coverage and uniform standards for patient privacy, especially via electronic communications.
HIPAA (Health Insurance Portability and Accountability Act)
A prepaid health plan that includes wellness ervices; enrollees are required to see a closed panel of providers
HMO (Health Maintenance Organization)
A comprehensive list and corresponding codes for diseases and disorders. HCFA and other payers use these codes for identifying the need for medical procedures
ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification)
This is scheduled to be required by the U.S. department of Health and Human Services on October 1, 2013. Codes will be significantly changed, going from a numerical framework to one that is alphanumeric. Moreover, the number of diseases and disorder codes will expand from approximately 4,000 to 68,000
ICD-10-CM
CMS maintains replicas of official record copies on the Internet. They include CMS program issuances, operating instructions, policies, and procedures based on statutes, regulations, guidelines, models, and directives.
IOM (Internet-Only Manual)
Private entities that administer the Medicare program locally to providers and beneficiaries. They are usually health insurance plans such as Blue Cross Blue Shield
MAC (Medicare Administrative Contractor)
A deliberative body composed of appointed experts in Medicare reimbursement and government staff that researches and adises Congress on payment policies and their effect on the budget and patient care
MedPAC (Medicare Payment Advisory Commission)
The listing of reimbursement rates by procedural codes for Medicare services billed by physicians and other practitioners. This was extended to institutional providers for SLP, OT, and PT services only.
MPFS (Medicare Physician Fee Schedule)
