Direction and management of a medical procedure given by the physician, but the doctor’s attendance is not necessary during the procedure (e.g., only available by telephone). Some medical procedures require general supervision to bill for a specific level of service. This level of supervision is never sufficient for meeting “incident-to” services. Also see direct supervision and personal supervision .

Physicians who have received training that encompasses several branches of medicine including internal medicine, preventive medicine, pediatrics, surgery, psychiatry, and obstetrics and gynecology. These doctors provide comprehensive medical care, problem solve, and coordinate total health care delivery to all members of a family regardless of sex or age.

General guidelines and detailed procedures of customary accounting practice that are established and interpreted by the Financial Accounting Standards Board (FASB). FASB was formed in 1973. These accounting principles are used by business firms outside of the insurance industry, as well as by health and life insurance companies.
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These principles have substantial authoritative support for use in the insurance business. They are intended to produce financial results consistent with those of other industries and to assure consistency in financial reporting.

Prescription drugs that have the same active ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. Also called generic equivalent .

Act of replacing a prescription brand drug for another drug that has the same active ingredient formula.

A state program for genetically disabled children.

Under the resource-based relative value scale (RBRVS) of the Medicare fee schedule, the weighted sum of the Geographic Practice Cost Indices (GPCI) for each geographic area. Also see geographic practice cost indices (GPCIs) .

In the Medicare program, this is a system used to convert the Medicare average United States fee-for-service per capita costs (USPCCs) to the local adjusted average per capita costs (AAPCCs). This is used to pay Medicare risk contracting health maintenance organizations (HMOs).

One of three components of the system in the Medicare program that is used in bringing fees for professional services in line for the region where each physician practices. It is pronounced “gypsies.” Under the resource-based relative value scale (RBRVS) of the Medicare fee schedule, the indices are numbers used to adjust the Relative Value Units for each component of a service (physician’s work, practice’s overhead, and malpractice costs) to reflect geographic differences in cost to provide the services. Each component is multiplied by its own GPCI. The GPCI is a single measure that combines the three fixed shares, whereas the geographic adjustment factor (GAF) of the Medicare fee schedule allows for each service to reflect different shares, thus creating a GAF for each service.