Author: Glossary
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Fraud and abuse
The criminal misuse of the Medicare system. The crime consists of such behavior as filing false claims for Medicare reimbursement (such as for nonexistent patients, or services that were never performed), paying or receiving “kickbacks” for patient referral, and so forth. Fraud and abuse is a felony which may be punished by fines up to…
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Fourth party
A term sometimes used in health care financing. The first two parties are the patient and the provider. The third party is a payer other than the patient, such as Blue Cross and Blue Shield (BC/BS), commercial insurance, or government. The term “fourth party” is sometimes used to designate industry or business, which buys health…
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For-profit
An entity organized under any of various business forms (corporation, partnership, sole-proprietorship, etc.) whose profits (excess of income over expenses) are returned to its members (shareholders, investors, owners) as dividends.
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Flexible spending account
An account managed by an employer that allows employees to set aside pretax funds for medical, dental, legal, and day-care services. FSAs may be components of “cafeteria plans” for providing health care which allow employees to choose among various levels of benefits.
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Fiscal period
An accounting period. A fiscal period is usually a year, and is therefore called a fiscal year.
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Fiscal intermediary
An agency, usually a Blue Cross Plan or private insurance company, selected by health care providers to pay claims under Medicare. Sometimes referred to simply as “intermediary.”
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Fiscal function
The sum of the activities, wherever performed, through which the hospital achieves fiscal (financial) soundness.
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Firewall
A defensive security system consisting of either, or both, hardware and software designed to protect computers from unwanted outside electronic intrusion, rather than direct physical tampering or theft. The term has gained significance as more and more computers are connected to each other via electronic networks, such as the Internet, where such unwanted electronic intrusion…
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Finding
An item of information about a patient which can only be elicited by laboratory, X-ray, or other diagnostic procedure, or by observation of the patient’s response to therapy. The physician relies on signs (disturbances of appearance or function which can be detected by the physician or another observer), symptoms (disturbances of appearance, function, or sensation…
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Financing finance
A method of obtaining money. Types available to hospitals include debt financing (borrowing money), equity financing (selling ownership—shares of stock—in the institution), tax-exempt bond financing (if available), and obtaining donations (of decreasing prominence at present).