Medicare insurance terms 18 to 34
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| fee schedule | a physician's listing of all reimbursement fees for all procedures performed in the practice
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| fiscal agent | fiscal agent and insurance company that processes and pays claims on behalf of a state Medicare carrier
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| H I can health insurance claim number | a 10 to 11 digit number assigned by Medicare to its beneficiaries
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| limiting charge | the highest amount a beneficiary can be charged for a covered service by non participating providers
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| Medicaid | provides health coverage for the categorically needy
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| Medicare | primarily for people older than 65 and others eligible for Social Security, Federal Insurance Program established in 1965 under the Social Security Act
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| Medicare managed care plans | these are health care choices such as HMOs Part C of the Medicare program
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| Medigap | health insurance policies sold by private companies, design to supplement or fill in the gaps between Medicare and the patient.
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| Non-assigned claim | a claim form which directs payment to the beneficiary
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| non participating physician | a position who has not entered into a written agreement with an insurance company to accept the plan's fee for services rendered
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| participating physician | a physician's who has entered into a written agreement with an insurance company to accept the Plan B for service rendered as payment in full
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| Premium | a dollar amount the insured person pays for insurance coverage
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| relative value studies RVs | relative values listed by health care procedure codes allows comparison of reimbursement for different codes
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| relative value unit RVU | the time that is multiplied by a monetary conversion factor to establish position payment for the resource-based relative value system or scale
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| remittance notice | paper summarized statement for providers including payments rejections for one or more beneficiaries
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| resource based relative value system scale RBRVS | a system that calculates position reimbursement for services using relative value units usual
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| usual, customary, and reasonable UCR | a method used by insurance carriers to establish provider payments based on the compendium of other like provider fee.
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