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officebiling 11,12

physicians office billing CH

ppl with low income and few resources categorically needy
agency that provides financial assistance to low income ppl temporaty assistance for needy families (TANF)
offers on opportuniey to develop plans for insurance coverage for uninsured children state childrens health insurance program (SCHIP)
provides health care to chilrn under age of 21 who are enrolled in medicaid EPSDT-early preventitive screening and diagnosis treatment
fee for service program that replaced the CHAMPUS program tricare standard
eligible for both medicaid and medicare medi-medi beneficiary
tricare term for coinsurance, the amount that is the Pts responsibility cost share
government health insurance program for veterans with 100% service related disabilities CHAMPVA
plan available for certain national guard and reserve members activated after 9/11 tricare reserve select
plan that provides no-cost care through civilian providers for service members that live and work more than 50 miles from nearest MTF tricare prime remote
plan all active duty service members are automatically enrolled in tricare prime
coordinates and manages tricare prime members care PCM (primary care manager)
alternative managed care plan for individuals who ant to recive services promarily from civilian facilities tricare extra
if a medicaid beneficiary is covered by a group plan, then medicaid would be the secondary payer
claims billed to medicare that are automatically sent to medicaid are called crossover claims
a classification for ppl with high medical expenses and low income, although not low enough to receive cash assistance medically needy
people classified as restricted status must see a specific provider
medicaid is run by state programs
two types of plans offered by medicaid are fee-for-service and managed care
for medicaid to receive federal matching funds, states must cover vaccines for children
for individuals enrolled in tricare-for-life, the primary payer would be medicare
maximum annual amount a tricare beneficiary must pay is called catastrophic cap
the worldwide database of tricare and champva beneficiaries is known as DEERS
Created by: cpar
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