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CRCS

Across
CMS file that contains patient eligibility and utilization data
Office of Inspector General
TThe person who is financially responsible for the patients bill
Federal Governments largest grant making agency
The portion of the bill that is paid in part or in full by the responsible party
Regulates laboratory licensing
A recorded claim against real or personal property
Allows the PCP to approve and authorize specialized services for members
An authorization provided by an insurance company approving the medical necessity for hospitalization or medical services
Administration for Community Living
Negotiated with insurance paid per member per month
Patient Self Determination Act
A Fixed amount established by the insurance company that a physician is permitted to collect from the covered patient each time they visit the doctor
Establishes requirements for medical screening exams
An estimate of time needed to collect the accounts receivable
Beneficiaries complete this to determine if Medicare is primary or secondary
Down
National Coverage Determination
Used in skilled nursing care
Freedom of Information Act
The person who owns the insurance policy.
A legally verified claim against a debtor validated by the court
Center for Disease Control and Prevention
Procedure by which a minor is freed from parental control
Local Coverage Determination
The amount covered charges by the insured that must be paid by the patient before benefits become payable by the insurance company
Aid to Families with Dependant Children
Total # of patient days divided by number of discarges
Department of Justice
Diagnostic medical screening. Of patients in advance of surgical procedures
Form signed by beneficiaries to help avoid write offs on claims that do not meet medical necessity
Patient protection and Affordable Care Act
A demand submitted to the insurer for the payment of Benefits under the insurance contract
Generally accepted accounting principles
Paid based on diagnosis in consideration of age co-morbidity and discarded status regardless of charges