Employment income covered by the hospital insurance (HI) program.

All employment and self-employment creditable for Social Security purposes, except in a few employment situations (e.g., religious orders under a vow of poverty, foreign affiliates of American employers), or the employer must elect state and local government coverage. However, as of July 1991 coverage became mandatory for state and local employees who do not participate in a public employee retirement system. All new state and local employees have been covered by Social Security since April 1986 except ministers or self-employed members of certain religious groups who can opt out of coverage. Covered employment for hospital insurance includes all federal employees, whereas covered employment for the Old Age, Survivors, and Disability Insurance (OASDI) Program includes some, but not all, federal employees.

1. Under the Health Insurance Portability and Accountability Act (HIPAA), this is a health plan, clearinghouse, or health provider who transmits health information and financial and administrative transactions in electronic form in connection with a HIPAA transaction. 2. From the perspective of the medical transcription service owner or independent contractor, the covered entity is the client. The CE is responsible for the protection of health information and, if there is a violation, can request documentation from its business associates to prove their compliance.

Defined health care charges that an insurer will consider for payment as listed in the terms of an insurance policy or contract. Also called covered services or coverage.

Under the Health Insurance Portability and Accountability Act (HIPAA), this phrase refers to the tasks (functions) of a covered entity, the performance of which makes the entity a health plan, health care provider, or health care clearinghouse.

Total of insured members of a managed care plan or individual or group insurance plan.

1. Specific health care services and supplies for which the insurance plan or federal or state program will provide reimbursement for covered persons under the terms of the plan; these consist of a combination of mandatory and optional services stated in each plan. 2. Services for which supplemental medical insurance (SMI) pays, as defined and limited by statute. Covered services include most physician services, care in outpatient departments of hospitals, diagnostic tests, durable medical equipment, ambulance services, and other health services that are not covered by the hospital insurance program. Also called coverage or covered expenses.

Person who has earnings creditable for Social Security purposes on the basis of services for wages in covered employment and/or on the basis of income from covered self-employment. The number of hospital insurance covered workers is slightly larger than the number of Old Age, Survivors, and Disability Insurance (OASDI)–covered workers because of different coverage status for federal employment.

1. See comparative performance report (CPR). 2. See electronic medical record (computer-based patient record). 3. See computer-based patient record (CPR). 4. Clinically this abbreviation may be translated as cardiopulmonary resuscitation. 5. See customary, prevailing, and reasonable (CPR) charge.