Services and care of a nonmedical nature to assist a patient in the activities of daily living (ADLs) on a long-term basis, usually for convalescent and chronically ill persons. This type of care includes acting as a companion and help in bathing, dressing, eating, preparation of special diets, supervision over self-administration of medications, using the toilet, and walking. Custodial care may or may not be a benefit of an insurance plan. In most cases, Medicare does not pay for custodial care but the Medicare home health benefit does pay for some personal care services.

Setting of care or institution that provides room, board, and other personal assistance services usually on a long-term basis and does not include a medical component.

1. Divorced parent the child lives with who bears the responsibility of the child’s medical expenses unless the divorce decree states otherwise. 2. Adoptive parent who becomes the legal parent of a child who was not born to him or her such as stepparent or relative and who bears the responsibility of the child’s medical expenses.

Employee who is legally responsible and has charge and custody of the care and handling for all the patient’s medical records in a hospital facility or physician’s medical practice. Electronically stored information has four levels of custodianship such as primary or direct custodian (e.g., staff nurse), data owner or steward (e.g., radiologist, pathologist, accountant), business associate and third party (e.g., claims clearinghouse, Internet service provider), and official record and system custodian (e.g., health information management department). Also called custodian.

1. Amount that a physician usually charges the majority of his or her patients. 2. Either the average fee charged for a specific procedure by all comparable physicians in the same geographical area or the 90th percentile of all the fees charged for a specific procedure by comparable physicians in the same geographical area.

From 1965 a method for determining an approved charge for a specific service for a physician before the implementation of the Medicare Fee Schedule in 1992. The approved charge is the lowest of the following three charges: the physician’s actual charge for the service, the physician’s customary charge for the service, and the charges made by each physician in the same geographical location. Currently, Medicare payment is based on a resource-based relative value scale (RBRVS) and not on CPR charges.

Division in a life and health insurance company that provides help to the company’s agents, policyholders, and beneficiaries. Types of service include supplying answers to requests for information, interpreting policy language, answering questions about insurance policy coverage, and making changes requested by the policyholder. This department also sends premium notices and collects premium payments, processes policy loans, dividends, and so on. Also called client service department, policy administration department, policy owner service department, and service and claim department.