MEDICARE
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| SPELL OF ILLNESS | BENEFIT PERIOD
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| RESPITE CARE | TEMPORARY HOSPITALIZATION OF PATIENT TO RELIEVE CAREGIVER
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| SURGICAL DISCLOSURE NOTICE | USED BY NO PAR ELECTIVE SURGERY OVER $500.00
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| LIFETIME RESERVE DAYS | "EXTRA" COVERED DAYS USED AT PATIENTS CHOICE
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| BENEFIT PERIOD | FIRST DAY OF HOSPITALIZATION THROUGH 60 DAYS DISCHARGED
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| MEDICARE SELECT | MEDIGAP THAT REQUIRES THE USE OF A NETWORK
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| DEMOSTRATION PROGRAM | TESTING A CHANGE IN POLICY
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| MEDICARE PART D | COVERS PRESCRIPTION COST
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| HOSPICE | PALLIATIVE CARE FOR TERMINALLY ILL PATIENTS
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| MEDICARE PART C | MEDICARE ALTERNATIVE FOR ADDITIONAL BENEFITS
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| MEDICARE PART B | PAYS FOR OUTPATIENT AND PHYSICIAN SERVICES
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| MEDICARE PART A | PAYS INPATIENT HOSPITAL, HOSPICE, HOME HEALTH, SNF
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| MEDIGAP | MEDICARE SECONDARY POLICY, PAYS WHAT MEDICARE DOESN'T
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| SEP | A SPECIAL TIME FOR A PERSON TO ENROLL DUE TO LIFE CIRCUMSTANCES
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| GEP | JAN 1 - MAR 31 EACH YEAR
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| IEP | STARTS 3 MONTHS BEFORE TURNING 65
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| 10 YEARS | HOW LONG YOU HAVE TO PAY TAXES INTO THE SYSTEM TO QUALIFY
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| DISEASE THAT QUALIFIES FOR MEDICARE (AUTOMATICALLY AT DIAGNOSIS) | END STAGE RENAL DISEASE "ESRD"
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| REQUIREMENTS FOR MEDICARE | AGE 65 OR DISABLED
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| LIMITING CHARGE | MAXIMUM A NON - PAR CAN CHARGE
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| NON - PARTCIPATING | DID NOT SIGN A CONTRACT WITH MEDICARE
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| MEDICARE CONDITIONALLY PRIMARY | WHEN THE PRIMARY PAYER ISN'T PAYING
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| MEDICARE AS PRIMARY | MEDICARE BEARS FIRST RESPONSIBILTY FOR PAYMENT
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| MEDICARE AS SECONDARY | MEDICARE BEARS SECOND RESPONSIBILTY FOR PAYMENT
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| MSP | MEDICARE SECONDARY PAYER
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| MSN | MEDICARE SUMMARY NOTICE
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| MEDICARE SUMMARY NOTICE | MONTHLY STATEMENT LIST CLAIM INFORMATION
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| MAC | MEDICARE ADMINISTRATIVE CONTRACTORS
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| DEADLINE FOR CLAIMS | ONE YEAR FROM DATE OF SERVICE
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| NON - PAR | DID NOT SIGN A CONTRACT WITH MEDICARE
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| "ABN" SIGNED JUST IN CASE | NON PARTICIPATING
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| EXPERIMENTAL PROCEDURES | MEDICARE SECONDARY PAYER
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| PAR | PARTICIPATING
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| BENEFIT FOR PARTICIPATINGS | DIRECT PAYMENT 5% INCREASED PAYMENT
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| CAN BE A HMO OR MEDICARE ADVANTAGE OR OPTIONAL MEDICARE ALTERNATIVE | MEDICARE PART C
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| PAYS FOR PHYSICIAN SERVICES AND PAYS FOR PHYSICAL OCCUPATIONA THERAPHY AND PAYS FOR OTPATIENT CARE | MEDICARE PART B
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| PAYS FOR HOSPITALIZATION AND HOSPICE AND HOME HEALTH AND SKILLED NURSING FACILITIES | MEDICARE PART A
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| HCPCS | HEALTHCARE COMMON PRODECURE CODING SYSTEMT
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| DME | DURABLE MEDICAL EQUIPMENT
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| DMEPOS | DURABLE MEDICAL EQUIPMENT PROSTHETIC, ORTHOTICS
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| HCPCS LEVEL 1 | CURRENT PROCEDURAL TERMINOLOGY ( CPT )
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| HCPCS II | NATIONAL CODES
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| HCPCS LEVEL 1 | IS FIVE DIGITS AND PUBLISHED BY AMERICAN MEDICAL ASSOCIATION
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| HCPCS LEVEL II | NATIONAL CODES THEY ARE FIVE CHARACTERS AND START WITH A LETTER FROM A-V
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| 5 TYPES OF HCPCS LEVEL II CODES | 1. PERMANENT 2. DENTAL 3. MISC 4. TEMP. 5. MODIFIERS
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| PERMANENT CODES | HCPCS NATIONAL PANEL WHICH IS COMPOSED BY REPS FROM BCBS, HEALTH INS. ASSOC (HIAA) AND (CMS) CENTER FOR MEDICARE AND MEDICAID SERVICES
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| DENTAL CODES | CONTAIN IN CURRENT DENTAL TERMINOLOGY (CDT) PUBLISHED BY AMERICAN DENTAL ASSOCIATION
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| MISC CODES | MISC./ NOT OTHERWISE CLASSIFIED CODES THAT ARE REPORTED WHEN A DMEPOS DEALER SUBMITS CLAIM FOR PRODUCT OR SERVICE WHICH THERE IS NO EXISTING HCPCS LEVEL II CODE - THEY CAN SUBMIT AS SOON AS FDA APPROVES
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| TEMP CODES | MAINTAINED BY CMS (UPDATED EVERY 3 YEARS)
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| CATERGORIES OF TEMP CODES | TRANSITIONAL PASS THRU PAYMENT OPPS (OUTPATIENT PROSPECTIVE PAYMENT SYSTEM)
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| MODIFIERS | GET ATTACHED TO A CODE THEY ARE TWO DIGITS THAT GET ADDED TO END OF CODE (DESC OF SERVICE BEEN ALTERED)
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| D,G,M,P, OR F | ARE REPORTED TO LOCAL MAC
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| B,E,K, OR L | ARE REPORTED TO REGIONAL DME / MAC
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| A,J,Q, OR V | REPORTED TO EITHER LOCAL MAC OR REGIONAL DME / MAC
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