Glossary: C
- CAHPS
- The Consumer Assessment of Healthcare Providers and Systems (CAHPS) program is a public-private initiative to develop standardized surveys of patients” experiences with ambulatory and facility-level care. For more information, see the Agency for Healthcare Research and Quality website: https://www.cahps.ahrq.gov/default.asp
- Capitation rate
- contract between an insurer and provider which specifies total payment for services over a period of time
- Capitation rate
- the maximum amount an insurer will pay for a specific medical service under a capitation agreement
- Carrier
- any entity engaged in the business of underwriting insurance
- Case manager
- person responsible for coordinating the treatment plans and health service providers for a patient
- Centers for Medicare and Medicaid Services (CMS)
- Previously known as the Health Care Financing Administration (HCFA), CMS is the agency responsible for the administration of Medicare and Medicaid programs.
- CHAMPUS
- medical insurance for active duty and retired members of the armed services and their families (TRICARE)
- Claim
- provider or beneficiary’s written or electronic request for payment of medical services rendered
- COBRA
- Consolidated Omnibus Budget Reconciliation Act, legally requires employers to offer continued medical insurance coverage under a group health plan after termination or reduction in work hours.
- Cognitive Impairment
- impairment of a person’s intelligence, judgment, learning, and memory to the extent of requiring supervision to preserve safety
- Coinsurance
- the amount, usually a percentage, of out of pocket expenses you will have to pay after you have met all deductibles and your insurance has finalized a claim
- Comprehensive Outpatient Rehabilitation Facility
- multi-disciplinary outpatient facility providing rehabilitations services under the supervision of a physician
- Concurrent review
- review by certified personnel of continuing inpatient stays to assess medical necessity
- Coordination of Benefits
- the determination of whether an insurer pays a claim as primary, secondary, or tertiary
- Coordination of Benefits Period
- thirty month period from the time of eligibility due to ESRD that a Medicare beneficiary’s employer or union health plan must be the primary payer before Medicare
- Copayment
- a fixed out of pocket expense that you are required to pay for certain services such as inpatient stays, doctor visits, prescriptions,and emergency services
- Covered services
- services eligible for payment under an insurance policy
- Crossover patient
- patient covered by Medicare and Medicaid insurance
- Current Procedural Terminology
- procedure for reporting medical services that assigns five digit codes to healthcare procedures and updated annually by the American Medical Association
- Custodial Care
- Non-clinical services to assist with activities of daily living,not generally covered by Medicare
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