Category: C

Painful after a blow or showing the marks of a bruise.  

Generally, the amount which a physician normally or usually cha/-(j(s the majority of his patients. Under Medicare, it is the median charge used by a particular physician for a specified type of service during the calendar year preceding the fiscal year in which a claim is processed. There is therefore, an average delay of a…

Board, room, and other personal assistance services generally’ provided on a long-term basis, which do not include a medical component. Such services are generally not paid for under private or public health insurance or medical care programs, except as incidental to medical care which a hospital or nursing home inpatient receives.  

In the Federal budget a budget that projects estimated budget authority and outlays for the upcoming fiscal year based on the continuance of existing programs without policy changes at the same levels of service as the fiscal year in progress. The Congressional Budget and Impoundment Control Act of 1974 requires that the President submit a…

A system of terminology and coding developed by the American Medical Association that is used for describing, coding and reporting medical services and procedures. A set of codes established for every diagnostic test and procedure. Using these codes makes it easier to track costs and patient records for insurance companies, Medicare, doctors and hospitals.  

Deprecating house-staff term for a patient who.se illness the house-staff (but not the patient) feels is unreal, nonphysical or insignificant. Use of the term should be discouraged since it often blinds the user to real patient needs, whether or not correctly perceived by the patient.  

The guarantee against specific losses provided under the terms of an insurance policy. Frequently used interchangeably with benefits or protection. The extent of the insurance afforded by a policy. Often used to mean insurance or an insurance contract. In health care reform discussions, “coverage” is most often used to describe the group of people for…

Provisions of a health insurance policy which require the insured or otherwise covered individual to pay some portion of his covered medical expenses. Several forms of cost-sharing are employed, particularly deductibles, coinsurance and copayments. A deductible is a set amount which a person must pay before any payment of benefits occurs. A copayment is usually…

Expenses incurred in the provision of services or goods. Many different kinds of costs are defined and used. Charges, the price of a service or amount billed an individual or third party, may or may not be the same as, or based on, costs. Hospitals often charge more for a given service than it actually…

One method of payment of medical care programs by third j)arties, typically Blue Cross plans or government agencies, for services delivered to patients. In cost-related systems, the amount of the payment is based on the costs to the provider of delivering the service. The actual payment may be based on any one of several different…