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Term&abrev 4020wk2

4020 Abbrevations and terminology week 2

MCD Medicaid
SCHIP State Children's Health insurance Program
MCHP Maternal and Child health program
TANF Temporary Assistance to Needy Families
AFDC Aid to Families with dependent Children
SSI Social Security income
EPSDT Early,Periodic Screening,Diagnosis and Treatment
MN Medically Necessary
CHDP Child Health and Disability Program
EOP Explanation of Payment
MFCU Medicaid Fraud Control Unit
DEFRA Deficit Reduction Act
QMB Qualified Medicare Beneficiary
TEFRA Tax Equity and Fiscal Responsibility Act
MQMB Medicaid Quailfied Medicare Beneficiary
C Codes Identifies items that may quailfy for"pass through" payments for hospital outpatient services
G Codes codes that usually would be assigned a cpt code for which there is no cpt assigned to date.
Q Codes Services that typically would not be assigned CPT codes, such as drugs, biological, medical equipment and supplies
S Codes Assigned for services such as drugs and supplies for which codes are need for the private insurance sector for polices, programs or claims proccesing
H Codes used by the state medicaid agenies to identify mental health sevices such as alcohol and drug treatment services
Categorically Needed Aged, blind, of diabled individuals or familes and children who meet financial eligiblity requirement for aid to familes with dependant children, supplemental security income or an optional state supplement
Covered Services specific services and supplies for which medicaid will provide reimbursment
Early and Periodic Screening, Diagnosis, and Treatment the EPSDT program covers screening and diagnostic services to determine physical or mental defects in recipients younger than 21 years of age and health care, treatment and other measures to correct of eliminate any defects and chronic conditions discover
Maternal and Child Health Program (MCHP)A state service organiaztion to assist children younger than21 years of age who have conditions leading to health problems
Medically Needed Persons in need of financial assistance or whose income and resources will not allow them to pay for the cost of medical care
Prior Approval The evaluation of a provider request for a specific service to determine the medical necessary and appropriateness of the care requested for a patient
Share of Cost The amount the patient must pay each month before he or she can be eligible for medicaid
Recipient A person certified by the local welfare department to receive the benefits of medicaid under one of the specific aid categories
Co-Insurance 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 patients payment of a portion of the coat at the time of service is rendered (AKA co-insurance)
Medicaid a federally aided, state operated and state administrated program that provides medical benefits for certain low income persons in need of health and medical care
Medi-Cal Cailf. version of Medicaid
Supplemental Security income a program of income support for low income, aged, blind, and disabled persons established by title xvi of the social security act
Created by: Lanealto88