Principles of Healthcare Reimbursement: Chapter 7 Key Terms
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each of the black spaces below before clicking
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| GPCI | geographical practice cost index
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| RBRVs | resource-based relative value
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| ASC | ambulatory surgical center
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| RVU | relative value unit
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| CF | conversion factor
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| PE | physician practice expense
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| WORK | physician work
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| MP | malpractice
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| PLI | professional liability insurance
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| MPFS or PFS | medicare physician (provider) schedule fee
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| SGR | sustainable growth rate
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| BN | budget neutrality
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| PQRS | physician quality reporting system
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| EP | elegible professionals
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| CAH | critical access hospital
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| APC | ambulatory payment classifications
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| AIRR | all inclusive reimbursement rate
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| ASC LIST | ambulatory surgery center list of covered procedures
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| BN ADJUSTOR | budget neutrality adjustor
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| BUNDLING | combination of supply and pharmaceutical costs or medical visits with associated procedures or services for one lump sum payment
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| CY | calendar year
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| FQHC | federally qualified health center
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| MAC | medicare administrative contractor
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| OCE | outpatient coding editor
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| RHC | rural health clinic
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| ANCILLARY SERVICES | professional healthcare services such as radiology, laboratory, or physical therapy
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| ASSIGNMENT OF BENEFITS | a contract between a physician and medicare in which the physician agrees to bill medicare directly for covered services, to bill the beneficiary only for any coinsurance or deductible that may be applicable, and to accept the medicare payment as payment
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| CARRIER | entity that has a contract with the centers for medicare and medicaid services (CMS) to determine and make medicare payments for part b benefits
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| CRITICAL CARE SERVICES | evaluation and management of critically ill or critically injured patients
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| DISCOUNTED FEE-FOR-SERVICE |
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| HOLD HARMLESS STATUS |
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| ELECTRONIC PRESCRIBING |
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| EPISODE OF CARE |
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| HOSPICE |
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| ELECTRONIC PRESCRIBING INCENTIVE PROGRAM |
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| MARKET BASKET |
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| NATIONAL UNADJUSTED COPAYMENT |
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| NATIONAL UNADJUSTED PAYMENT |
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