by Experts
HIPPA Health Insurance Portability Accountability Act 1996-
EMTALA emergency medical treatment and active labor act-says no one can be
discriminated against due to economic status
Statistical Reporting provides summary of information for improvement
Clinical Data Repository CDR provides ready access to information from a variety of
sources within a healthcare network; the process of reviewing adjudicating and processing claims
Acute Care patients who require a stay for several days requiring constant medical care
Adjusted patient days yearly patient days adjusted by ratio of outpatient revenue to total
revenue
,Advance Beneficiary Notice ABN (only in original medicare plan) notice given to
beneficiary when Medicare is expected to deny payment
Aid to Families with Dependent Children (AFCD) used to be TANF federal and state
program that gives assitance to needy families. It is based on state's standards
Ambulatory Care Mobile care given to patients that do not need to stay over night
All Patient Diagnosis Related Groups APDRG how patients are processed for Medicare
and Medicaid
Ancillary Services in a hospital setting ex. lab work; x-rays/ services related to care
Assignment agreement from physician saying they will bill Medicare directly and will
accept their payment as full payment
Attending physician Caregiver
, Average Daily Census the average of inpatients per day
Bundled Billing AKA global package) combining all medical services into one bill ex.
maternity care
Balanced Billing If non-par.provider this makes you responsible for the difference
between the amount paid by insurance
Centers For Medicare and Medicaid Services agency within the U.S. Dept. of human
services responsible for adminis. the Medicare and Medicaid progarm (formerly HCFA-
healthcare financing Andministration
Wayfinding signage system that directs patients and families where to go
Tricare/ Champva healthcare program run by Dept. of Defense
Health Maintenance Organization type of insurance that with certain health care
providers using fixed fee structures or cap. rates