1. Doctor who sends the patient for testing or treatment noted on the insurance claim when submitted by the physician performing the service. 2. When completing the CMS-1500, the referring physician’s complete name and degree is inserted in Block 17 and his or her national provider identifier (NPI) is placed in Block 17a of the paper claim form.

Money returned by an insurance company to a group or individual.

Type of annuity that gives back premiums plus interest to a beneficiary if the annuitant dies during the accumulation period.

Internationally recognized informatics and health care research organization dedicated to the improvement of health through research that enhances the quality and cost-effectiveness of health care. The institute offers education and training opportunities in academic and research careers. It maintains the logical observation identifiers, names, and codes (LOINC) system that is being considered for use as part of the HIPAA claim attachments standard.

Health information organization that brings together health care associations in a specific geographical area and governs health information exchange between them to improve health and care in that community.

Four national Medicare fiscal intermediaries contracted to process Medicare home health and hospice claims, audit home health physicians, and check on the quality of home health care. Also called contractor .

Location where comprehensive medical services are provided to serve a large area. Not a tertiary care center.

1. Social Security state office. 2. Centers for Medicare and Medicaid Services (CMS) has 10 ROs that work closely together with Medicare contractors in their assigned geographical areas on a day-to-day basis. Four of these ROs monitor network contractor performance, negotiate contractor budgets, distribute administrative monies to contractors, work with contractors when corrective actions are needed, and provide a variety of other liaison services to the contractors in their respective regions.