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Chapter 6 Vocabulary - Reimbursement

Teacher: Nanci Cross
Across
A contracting authority to administer Part A and Part B - replaced Fiscal Intermediaries.
Short name of a diagnosis-related group
A hospital engaged in an approved graduate medical education residency program in medicine, osteopathy, dentistry, or podiatry
Professional direct contact between a patient and a provider who delivers services
Cases in PPS with especially long stays-high costs
Inpatient classification that that categorizes patients who are similar in diagnosis and treatment, age, and resources.
Software module in Medicare claims, specific to certain benefits, used in pricing claims and calculating payment rates.
Down
Cost of living adjustment
Patient admitted to hospital
This Federal document is a daily publication of the US Government Printing Office
Program that uses data elements to assign patients to groups or categories
Under IPPS, a transfer to a nonacute-care setting for designated MS-DRGs is treated as an IPPS to IPPS transfer when established criteria are met