HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating a mental health/substance abuse program. This modifier may be required for state Medicaid programs, so check with your state guidelines.
Insurance Encyclopedia
HI
1. HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating an integrated mental health and mental retardation/developmentally disabled program. This modifier may be required for state Medicaid programs, so check with your state guidelines. 2. Medicare Part A; see hospital insurance .
HIAA
Abbreviation for Health Insurance Association of America, which is now known as America’s Health Insurance Plans (AHIP) . See America’s Health Insurance Plans (AHIP) .
Hidden Reserve
Under English Law Insurance companies are allowed to hold reserves that do not appear in their published accounts which may, for example, show their investments at less than their true value.
hierarchical condition categories (HCC) model
Risk adjustment prospective payment system used by Centers for Medicare and Medicaid Services (CMS) for managed care organizations (MCOs). It uses a hierarchical diagnosis classification system and other demographic adjusters to foretell costs and establish payment amounts for managed care services to Medicare beneficiaries.
Hierarchy
Numerical order of diagnostic codes in which each digit beyond three digits adds information. See Box H-3 .Box H-3ALPHANUMERICAL CODES FOR ICD-10-CMFRACTURE OF UPPER LIMB (810-819)810 Fracture of clavicleIncludes: collar boneinterligamentous part of clavicleThe following fifth-digit subclassification is for use with category 810:0 unspecified partClavicle NOS1 sternal end of clavicle2 shaft of clavicle3 acromial end of clavicle 810.0ICD-10-CMS42.00 Closed fracture of clavicleS42.001 Closed fracture of right clavicleS42.002 Closed fracture of left clavicleS42.009 Closed fracture of clavicle, unspecified side
high complexity (HC)
Phrase used to describe a type of medical decision making when a patient is seen for an E/M service.
High Deductible Health Plan (HDHP)
A health insurance plan that carries deductibles and out-of-pocket expense limits that are higher than certain IRS-mandated limits.
High level reinsurance
(1) reinsurance with a large excess; (2) in the context of a reinsurance spiral, it means that the reinsurer is many steps away from the direct insurer.
High Pressure Selling
The action of encouraging the buyer to purchase Insurance without full consideration of needs for Insurance and his liability to payments for the Insurance.