Process of the gradual retirement of an outstanding debt by making periodic payments over a stated period of time.
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UK: Periodical reduction in the value of a lease or other time-related asset until the asset is written down to nil. In insurance it is the ability to match the cost of cover to the actuarial probability of risk over time. Pension scheme actuaries spread an actuarial surplus or actuarial deficiency over an appropriate period.
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Writing off part of the value of an asset in a company’s books at intervals until the value of an asset is extinguished.
Fee charged for the medical services rendered to a patient by a provider and submitted or transmitted by the provider on an insurance claim form. When the provider is billing, this total charge is inserted in Block 28 of the CMS-1500 insurance claim form. When the hospital is billing, this total charge is inserted in Field 47 of the UB-04 insurance claim form.
In the Medicare program, the dollar amount of a medical service that has been denied and then appealed by the provider and patient to the insurance carrier for redetermination.
Medicaid parameters defining a state’s benefits. Because each state has different Medicaid plans, these benefits will vary from state to state.
In Healthcare Common Procedure Coding System (HCPCS) Level II coding, two alphanumeric characters placed after the usual five-digit CPT procedure code number. These modifiers are used to identify specific anatomical parts of the body when the CPT procedure code does not include that information. HCPCS modifiers are accepted by insurance carriers nationally and are updated annually by the Centers for Medicare and Medicaid Services (CMS).
Large medical group composed of multispecialists with multidisciplines that under managed care contracts handle the bulk of treatments and referrals of member patients and carry most of the clinical risk. Also called key groups or core groups.
Supplemental health care service required as part of giving other care such as anesthesia, laboratory, pharmacy, and radiology; other than routine hospital services (room, board, medical and nursing services).
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Fees charged for additional services (other than room and board charges), such as x-rays, anesthesia, lab work, etc. The term may also be used to describe the charge made by a pharmacy for prescriptions which exceed the health insurance policy’s maximum allowable cost.
Fee for an ancillary service that is sometimes billed as an additional service such as anesthesia, laboratory, pharmacy, or radiology charge and which may exceed the managed care plan’s maximum allowable.
Medical professional with a limited license to practice medicine and therapy who may bill for these services. See also nurse practitioner (NP), physician extender (PE), and physician assistant (PA).
1. Supportive professional services other than room, board, and routine hospital services that are incidental to the hospital stay and provided by the facility such as ambulance, anesthesia, blood administration, drugs, laboratory tests, pharmacy, operating room, x-rays, medical, surgical, and central supplies; physical, occupational, and speech therapy; and inhalation therapies. Also called inpatient ancillary services. 2. In a medical office setting, ancillary medical services may consist of diagnostic tests such as x-rays or laboratory tests.