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MOD3520 WEEK2
MOD3520 WK2 TERMINOLOGY
| Question | Answer |
|---|---|
| C CODES | IDENTIFIES ITEMS THAT MAY QUALIFY FOR "PASS THROUGH" PAYMENTS FOR HOSPITAL OUTPATIENT SERVICES |
| G CODES | CODES THAT USUALLY WOULD BE ASSIGNED A CPT CODE FOR WHICH THERE IS NO CPT CODE ASSIGNED TO DATE |
| Q CODES | SERVICES THAT TYPICALLY WOULD NOT BE ASSIGNED CPT CODES,SUCH AS DRUGS,BIOLOGICAL,MEDICAL EQUIPMENT,AND SUPPLIES |
| S CODES | ASSIGNED FOR SERVICES SUCH AS DRUGS AND SUPPLIES FOR WHICH CODES ARE NEEDED FOR THE PRIVATE INSURANCE SECTOR FOR POLICIES, PROGRAMS, OR CLAIMS PROCESSING |
| H CODES | USED BY THE STATE MEDICAID AGENCIES TO IDENTIFY MENTAL HEALTH SERVICES SUCH AS ALCOHOL AND DRUG TREATMENT SERVICES |
| CATEGORICALLY NEEDED | AGED,BLIND,OR DISABLED INDIVIDUALS OR FAMILIES AND CHILDREN WHO MEET FINANCIAL ELIGIBILITY REQUIREMENTS FOR AID TO FAMILIES WITH DEPENDENT CHILDREN,SUPPLEMENTAL SECURITY INCOME OR AN OPTIONAL STATE SUPPLEMENT |
| COVERED SERVICES | SPECIFIC SERVICES AND SUPPLIES FOR WHICH MEDICAID WILL PROVIDE REIMBURSEMENT |
| EARLY AND PERIODIC SCREENING,DIAGNOSIS,AND TREATMENT | THE EPSDT PROGRAM COVERS SCREENING AND DIAGNOSTIC SERVICES TO DETERMINE PHYSICAL OR MENTAL DEFECTS IN RECIPIENTS YOUNGER THAN 21 YEARS OF AGE AND HEALTH CARE, TREATMENT , AND OTHER MEASURES TO CORRECT OR ELIMINATE ANY DEFECTS AND CHRONIC CONDITIONS DISCOV |
| MATERNAL AND CHILD HEALTH PROGRAM (MCHP) | A STATE SERVICE ORGANIZATION TO ASSIST CHILDREN YOUNGER THAN 21 YEARS OF AGE WHO HAVE CONDITIONS LEADING TO HEALTH PROBLEMS |
| MEDICALLY NEEDED | PERSONS IN NEED OF FINANCIAL ASSISTANCE OR WHOSE INCOME AND RESOURCES WILL NOT ALLOW THEM TO PAY FOR THE COSTS OF MEDICAL CARE |
| PRIOR APPROVAL | THE EVALUATION OF A PROVIDER REQUEST FOR A SPECIFIC SERVICE TO DETERMINE THE MEDICAL NECESSARY AND APPROPRIATENESS OF THE CARE REQUESTED FOR A PATIENT |
| SHARE OF COST | THE AMOUNT A PATIENT MUST PAY EACH MONTH BEFORE HE OR SHE CAN BE ELIGIBLE FOR MEDICAID |
| RECIPIENT | A PERSON CERTIFIED BY THE LOCAL WELFARE DEPARTMENT TO RECIEVE THE BENEFITS OF MEDICAID UNDER ONE OF THE SPECIFIC AID CATEGORIES |
| CO-INSURANCE | A COST SHARING REQUIREMENT UNDER A HEALTH INSURANCE POLICY PROVIDING THAT THE INSURED WILL ASSUME A PERCENTAGE OF THE COST FOR COVERED SERVICES |
| CO-PAYMENT | A PATIENTS PAYMENT OF A PORTION OF THE COST AT THE TIME OF SERVICE IS RENDERED;SOMETIMES REFERED TO AS A COINSURANCE |
| MEDICAID | A FEDERALLY AIDED, STATE OPERATED AND STATE ADMINISTERED PROGRAM THAT PROVIDES MEDICAL BENEFITS FOR CERTAIN LOW INCOME PERSONS IN NEED OF HEALTH AND MEDICAL CARE |
| MEDI-CAL | CALIFORNIAS VERSION OF THE NATIONWIDE PROGRAM KNOWN AS MEDICAID |
| SUPPLEMENTAL SECURITY INCOME | A PROGRAM OF INCOME SUPPORT FOR LOW INCOME,AGED,BLIND,AND DISABLED PERSONS ESTABLISHED BY TITLE XVI OF THE SOCIAL SECURITY ACT |
Created by:
reginacamarena
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