Situation in which a provider bills for midlevel services for various patient encounters under the assumption that some visits will be a little higher and some will be a little lower (upcoding some services and downcoding other services).
Insurance Encyclopedia
CME
Acronym that means continuing medical education. See continuing education (CE).
CMOS (Collateralised Mortgage Obligations)
Similar to CDOs except that they are backed exclusively by mortgages rather than diversified loans. The cash inflows of the SPV are also divided into layers or tranches, each of which has a different payback period and seniority profile based on security.
CMR Convention (Contract de Merchandises par Route)
Governs cross-border European road carriage and was enacted in the UK by the Carriage of Goods by Road Act 1965. CMR applies to the carriage of goods by road when the place of taking over the goods and the delivery place are in two different countries at least one of which is a contracting party. Any road journey for hire or reward (not own goods carriage) that starts or ends in the UK is subject to CMR unless an exception (e.g. furniture removal, postal despatch) applies. The carrier is liable for loss or damage from taking charge of the goods until delivery subject to a compensation limit based on a rate per kilo. There is no liability if a defence (e.g. wrongful act or neglect of the claimant) applies.
CMS agent
Any individual or organization, public or private, with whom the Centers for Medicare and Medicaid Services (CMS) has a contractual arrangement to contribute to or participate in the Medicare survey and certification process. The state survey agency is the most common example of a CMS agent as established through the partnership role that the state agency (SA) plays in the survey process under the provisions of §1864 of the Act. A private physician serving a contractual consultant role with the SA or CMS regional office as part of a survey and certification activity is another example of a CMS agent.
CMS Data Center User Form
See: Centers for Medicare and Medicaid Services (CMS) Data Center User Form.
CMS directed improvement project
Any project where Centers for Medicare and Medicaid Services (CMS) specifies the subject, size, space, data source, analytical techniques, educational intervention techniques, or impact measurement model. These projects may be developed by CMS in consultation with networks, the health care community, and other interested people.
CMS manual system
See: Medicare Carriers Manual (MCM).
CMS-1450
Medicare Uniform Institutional Provider Bill (insurance claim) form used for submission after hospital services have been provided to a patient. This is commonly known as the Uniform Bill (UB-04) institutional claim form, which replaces the Uniform Bill (UB-92) claim form. See Uniform Bill (UB-04) claim form.
CMS-1500
Health Insurance Claim Form, a uniform professional insurance claim form used for submission after medical services have been provided to a patient. See Health Insurance Claim Form (CMS-1500).