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Ms. Moneybags

Ms. Moneybags Understanding Health Insurance. -Intro to H.I. ch.2

Term, Acronym or QuestionAnswer
Insurance Contract that protects the insured from loss
PIP Personal Injury Protection
Disability Insurance reimbursement for income lost as a result of a temporary or permanent illness or injury
Liability Insurance policy that covers losses to a third party caused by the insured, object owned by the indured or on premises owned by insured
FECA Federal Employees Compensation Act
Date of the first health insurance policy 1860
Date of first Blue Cross Policy 1929
Date of first Blue Shield Plan 1939
Group health Insurance health care coverage available through employers and other organizations. Employers usually pay part or all of premium costs
Hill Burton Act provided federal grants for modernizing hospitals that had become obsolete during Great Depressiona and WWII. In return, facilities were required to provide free or reduced service to patients unable to pay for care
TPA Thrid Party Administrators
Third Party Administrators administer health care plans and process claims, serving as checks and balance system for laboar and management
WHO World Health Organization
Inpatient Patient admitted to hospital with the expectation of staying atleast 24 or more
SSA Social security Administration
Date of implementation of SSA Amendments for Medicare and Medicaid 1966
CHAMPUS Civilian Health And Medical Program-Uniformed Services
OSHA Occupational Safety and Health Administration Act of 1970
Occupational Safety and Health Administration Act of 1970 protects all employees against injuries from occupational hazards in the workplace
CHAMPVA Civilian Health and Medical Program of the Department of Veterans Affairs
HMO's Health Maintenance Organizations
ERISA Employee Retirement Income Security Act of 1974
HCFA Health Care Financing Adminstration, replaced by CMS
DHHS Department of Health and Human Services
PSRO's Professional Standards Review Organizations, replaced by PRO's
PRO's Peer Review organizations
CMS Centers for Medicare and Medicaid Services
PPS Prospective Payment System
per diem reimbursement per day charge
DRG Diagnosis Related Groups
COBRA Consolidated Omnibus Budget Reconciliation Act of 1985
Consolidated Omnibus Budget Reconciliation Act of 1985 allows employees to continue health care coverage beyond the benefit termination date
CLIA Clinical Laboratories Improvement Act
NCQA National Committeee for Quality Assurance. they developed HEDIS
HEDIS Health Plan Employer Data and Information SET
Health Plan Employer Data and Information SET created standards to assess managed care systems using data elements that are collected, evaluated, and published to compare the performance managed health care plans
RBRVS Resource Based Relative value Scale System
Usual and Resonable payments based on fees typically charged by providers by specialty within a particular region of the country
NCCI National Correct Coding Initiative
National Correct Coding Initiative developed to promote national correct coding methodologies and to eliminate improper coding
Created by: msmoneybags