Individual younger than age 65 who has been entitled to disability benefits under Title II of the Social Security Act or the Railroad Retirement system for at least 2 years and who is enrolled in the supplemental medical insurance (SMI) program.

Series of payments, each of which is conditional on a person being alive and still disabled.

Funds set aside for payment of currently recognized or future claims on lives of disabled insureds.

Provider’s fee that is above an insurance plan’s fee ceiling (maximum allowable) and which the insurance company does not recognize for payment. Also referred to as disallowed amount, nonallowed amount , or contractual disallowance .

When related to the health care setting, this refers to the patient’s formal release from the hospital as an inpatient or if a patient voluntarily departs the hospital. Types of discharge are discharge by death, discharge by transfer, and discharge to home. The discharge hour is inserted in Field 16 and patient discharge status is entered in Field 17 of the Uniform Bill (UB-04) inpatient hospital billing claim form.

Month, day, and year that the patient is formally released from the hospital or skilled nursing facility (e.g., patient left against medical advice, patient released to home, patient transferred to a skilled nursing facility or acute care hospital, patient expired).

One or more of the diagnoses listed after all the information from tests and observation have been obtained during the present course of a patient’s hospital stay. This identification is given at the time of hospital discharge.

Procedure codes 99238 and 99239 indicate the provider takes full responsibility for the patient’s entire hospital stay.