AFC - Acute Care Facility - Question and answersA health facility providing continuous
professional medical care to patients who are in an acute phase of illness.
Ambulatory Surgery - Question and answersSurgical procedures performed on a patient
who is admitted, treated and released on the same day.
ASC - Question and answersAmbulatory Surgical Center
ASC Surgical Procedures - Question and answersSurgical procedures performed on an
outpatient basis in an ASC.
Clinic - Question and answersAn outpatient facility that provides scheduled diagnostic,
curative, rehabilitative, and education services for walk-in (ambulatory) patients.
Consultation - Question and answersAdvice or option rendered the request of another
qualified provider.
Cost Report (Medicare) - Question and answersAn annual report required of facility
contractors participating in the Medicare program. The report details the cost and
charges the provider incurred in rendering services to all patients and the Medicare
payments received during a specific reporting period. Cost and reporting procedures are
defined by the Medicare program.
CAH - Critical Access Hospital - Question and answersA hospital certified under a set of
Medicare Conditions of Participation (CoP), which are structured differently than the
acute care hospital CoP.
DRG - Diagnosis Related Group - Question and answersA patient classification scheme
providing a means of relating the type of patients hospital treats (ie, it's a case mix) to
the cost incurred by the hospital.
Diagnostic Laboratory Services - Question and answersLaboratory services required in
the diagnosis of a disease or injury, regardless of where the services are rendered. For
Medicare purposes, these services are paid under a separate fee schedule. These
services include clinical lab tests performed on automated multichannel analyzers.
, Diagnostic Services - Question and answersAn examination or procedure performed on
a patient to obtain information to assess the medical condition of the patient or to
identify a disease and/or to determine the nature and severity of a disease or injury.
Diagnostic X-ray Services - Question and answersX-ray and other related imaging
services performed for diagnostic purposes, including portable X-ray services.
EMTALA (Emergency Medical Treatment and Active Labor Act) - Question and
answersEMTALA requires any Medicare-participating hospital that operates a hospital
emergency department to provide an appropriate medical screening examination to any
patient that requests such an examination.
LTCH - Long-Term Care Hospital - Question and answersThese facilities are certified
as acute care hospitals, but LTCHs focus on patients who, on average, stay more than
25 days. LTCHs specialize in treating patients who may have more than one serious
condition, butwho may improve with time and care, and return home.
Medical Documentation - Question and answersIncludes the following types of
patient care records: operative notes; physical, occupational,
and speech-language pathology notes; progress notes; physician
certification and recertification; emergency room records,
and the patient's medical record in its entirety
Medicare Carriers Manual - Question and answersA manual that encompasses
Medicare's policies regarding billing and reimbursement. The document is created and
maintained by CMS, which provides it to Medicare Administrative Contractors (MACs)
(local Part B carriers and fiscal intermediaries [FI]s) to assist with uniform
reimbursement.
Medicare Hospital Manual - Question and answersManual containing information issued
to hospitals participating in the Medicare program. It contains the policies and
procedures applicable to the delivery of hospital services, claim process instructions,
billing procedures, coverage requirements, and related Medical matters.
Medicare Provider - Question and answersA facility, supplier, or physician who
furnishes Medicare services.
MLP - Midlevel Practitioners - Question and answersProfessionals without physician
input or under physician direction, also called NPPs. (eg, nurse practitioner, nurse
midwives, physicians assistant)
Non-payment Services - Question and answersServices rendered to a patient not
admitted as an inpatient or outpatient at the hospital. This term typically refers to
laboratory test performed on samples sent to the hospital laboratory from an outside
source to process. The account is established, but the services are rendered on the
specimen rather than to a patient seen at the hospital.
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