In 2003, HIAA, Group Health Association of America (GHAA), and the American Managed Care and Review Association (AMCRA) merged with American Association of Health Plans (AAHP) and created what is now known as America’s Health Insurance Plans (AHIP) . See America’s Health Insurance Plans (AHIP) .

Request for payment on behalf of the insured (patient) to an insurance company for professional services rendered by a provider.

1. Professional uniform insurance claim form developed and approved by the American Medical Association Council on Medical Service and the Centers for Medicare and Medicaid Services. The version in current use is the CMS-1500 (08-05). It is also known as the UCF-1500 . It is used by physicians and other professionals to bill outpatient services and supplies to Medicare, TRICARE, and some Medicaid programs, as well as some private insurance carriers and managed care plans. Formerly known as HCFA-1500 . 2. For electronically transmitted professional claims, the 837P replaces the paper CMS-1500 form and the electronic national standard format (NSF). 3. In Medicare fraud, altering insurance claim forms to obtain a higher payment amount.

Unique nine-digit Medicare entitlement number assigned to an individual by the Social Security Administration. It appears on the Medicare beneficiary’s identification card and is used when submitting an insurance claim to the fiscal intermediary for payment. The HICN is used with a one- or two-letter or one-letter and one-number suffix. A letter prefix may indicate that the beneficiary is entitled to railroad retirement benefits.

Under the Health Insurance Portability and Accountability Act (HIPAA), an insurance company, insurance service, or insurance organization that is licensed in the state to do business involving insurance and is subject to the state’s laws regulating insurance. This phrase does not include a group health insurance plan.

Groups of businesses that join together to lobby for better insurance policies or lower premiums from insurance companies.

Allows an individual to keep an employer-group medical insurance plan when changing jobs. See Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) .

Federal law designed to limit exclusions for preexisting conditions, prohibit discrimination against employees and dependents based on their health status, guarantee that health insurance is available to small employers, and guarantee renewability of insurance to all employers regardless of size. However, people must go through the Consolidated Omnibus Budget Reconciliation Act program before using HIPAA. HIPAA allows portability in that it provides continuing insurance coverage when a person changes employment. It also simplifies administrative aspects of electronic health care transactions; mandates standard transaction code sets used by providers, plans, payers, and employers; and orders security, privacy, and confidentiality of patients’ health information via electronic transmission. HIPAA requires use of national identification systems for health care patients, providers, payers or plans, and employers. This act is also known as K2, Kennedy-Kasselbaum Bill, Kennedy-Kassenbaum Bill , and Public law 104-191 .