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bill & ins c 13

key terms and abbreviations

TermDefinition
categorically needy aged, blind, or disabled individuals or families and children who meet financial requirements for aid to families with Dependent Children, Supplemental Security Income, or and optional state supplement
Coinsurance 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 patient's payment of a portion of the cost at the time the service was rendered
covered services specific services and supplies for which Medicaid will provide reimbursement: these consist of a combination of mandatory and optional services stated in the plan.
EPSDT Early and Periodic Screening, Diagnosis, and Treatment. the EPSDT program cover screening and diagnostic services to determine physical or mental defects in recipients younger than 21 years of age and health care, treatment etc... for chronic cond & defec
Fiscal agent an organization under contract to state to process claims for a state Medicaid program: insurance carrier handling claims from physicians and other supplies of service for Medicare part B; also referred ad fiscal intermediary
MCHP Maternal and Child Health Program. A state service organization to assist children younger than 21 years of age who have conditions leading to health problems
Medi-cal California's state Medicaid program name
Medicaid A federal aided, state-operated and administered program that provides medical benefits for certain low-income persons in need of health and medical care
MN Medically Needed. Person in need of financial assistance or whose income and resources will not allow them to pay for the care requested for a patient
Recipient A person certified by the local weifare department to receive the benefits of Medicaid under one of the specific aid categories: an individual certified to receive Medicare benefits.
share of cost Amoun patient must pay each month before he/she can be elegible for Medicaid. Also known as liability spend down.
SCHIP State Children Health Insurance Program. A state health program that operates with federal grant support under title V of the Social Security Act. In some states this program may be known as Maternal and Child Health program
SSI Supplementary Security Income. A program of income support for low income aged, blind, and disabled persons established by the title XVI of the Social Security Act
Created by: jvalladolid