Consumer Price Index is a measurement used to track changes in the average prices paid over time for a fixed group of goods and services. 🧠 Full Definition The term Consumer Price Index refers to an inflation measurement that tracks how prices change over time for a standardized collection of … [Read more...] about Consumer Price Index

Conditional Payment is a temporary payment Medicare makes for healthcare services when another insurer or payer is expected to be primarily responsible for the costs. 🧠 Full Definition The term Conditional Payment refers to a Medicare payment made for covered healthcare services when another … [Read more...] about Conditional Payment

Outpatient Prospective Payment System Coinsurance is the portion of outpatient healthcare costs a beneficiary pays after meeting the Medicare Part B deductible. 🧠 Full Definition The term Outpatient Prospective Payment System Coinsurance refers to the percentage of the Medicare payment rate or … [Read more...] about Outpatient Prospective Payment System Coinsurance

Medicare Private Fee-for-Service Coinsurance is the percentage of healthcare service costs a beneficiary may pay under a Medicare Private Fee-for-Service (PFFS) plan after meeting applicable deductibles. 🧠 Full Definition The term Medicare Private Fee-for-Service Coinsurance refers to the … [Read more...] about Medicare Private Fee-for-Service Coinsurance

Claim is a request submitted for payment of healthcare services or benefits provided under Medicare coverage. 🧠 Full Definition The term Claim refers to a formal request for payment submitted for healthcare services, supplies, or benefits received by a Medicare beneficiary. Claims are used by … [Read more...] about Claim

Certificate of Indebtedness is a short-term federal debt security representing ownership of a portion of government debt that pays a fixed rate of interest. 🧠 Full Definition The term Certificate of Indebtedness refers to a short-term government debt instrument, typically issued for 12 months or … [Read more...] about Certificate of Indebtedness

Catastrophic Limit is the maximum amount a beneficiary must pay out of pocket for certain covered healthcare expenses during a specified time period. 🧠 Full Definition The term Catastrophic Limit refers to a financial protection threshold that caps the amount a beneficiary is required to pay for … [Read more...] about Catastrophic Limit

Cash Basis is an accounting method that records costs and expenses when payment is made rather than when services are performed. 🧠 Full Definition The term Cash Basis refers to an accounting approach in which healthcare costs, expenses, or revenues are recognized at the time money changes hands … [Read more...] about Cash Basis

Capitation is a fixed payment arrangement where a health plan or healthcare provider receives a set amount of money to cover a member’s healthcare services over a specified period. 🧠 Full Definition The term Capitation refers to a payment model in which a healthcare provider or health plan … [Read more...] about Capitation

Callable Bond is a bond or investment security that may be redeemed by the issuer before its scheduled maturity date after proper notice is given. 🧠 Full Definition The term Callable Bond refers to a bond or similar debt security that is subject to redemption before maturity upon notice by the … [Read more...] about Callable Bond

Provider Bonus is additional compensation paid to a physician or healthcare entity beyond standard salary, fee-for-service payments, capitation, or returned withhold amounts. 🧠 Full Definition The term Provider Bonus refers to supplemental payments made to physicians or healthcare organizations … [Read more...] about Provider Bonus

Bond is a federal debt security representing ownership of a portion of money borrowed by the United States government and repaid with interest. 🧠 Full Definition The term Bond refers to a certificate representing ownership of part of a debt obligation issued by the federal government. Bonds pay … [Read more...] about Bond

Benefit Payments are the amounts Medicare or another health plan pays for covered healthcare services after applicable deductibles and coinsurance have been applied. 🧠 Full Definition The term Benefit Payments refers to payments made for covered medical services after deductibles, coinsurance, … [Read more...] about Benefit Payments

Base Estimate is an updated projection for the most recent historical year used in Medicare financial and actuarial analysis. 🧠 Full Definition The term Base Estimate refers to the revised estimate for the latest completed historical year used as a starting point for future Medicare financial … [Read more...] about Base Estimate

Surprise Balance Billing occurs when a healthcare provider bills a patient for charges not fully covered by the health plan, often involving out-of-network services. 🧠 Full Definition The term Surprise Balance Billing refers to situations where a provider bills a beneficiary for the difference … [Read more...] about Surprise Balance Billing