Form of health maintenance organization (HMO) that limits the patient’s choice of personal physicians to those doctors practicing in the HMO group practice within the geographical location and/or facility. Such plans allow members to receive nonemergency medical services, but adhering to a closed panel is usually not applicable to emergency care. A physician must meet very narrow criteria in order to join a closed panel.

Alignment of a fracture without the site opened for surgical intervention. Three treatment methods for closed fractures exist: without manipulation, with manipulation, and with or without traction.

That portion of the insurance sales presentation when a prospective applicant has made a purchase commitment for insurance coverage and signs the sales proposal or application form.
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Completion of an insurance.

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).

Acronym that means continuing medical education. See continuing education (CE).

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.

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.