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CRCS

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