Government Insurance Programs

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Medicare

A federal health insurance program for people over 65, those with qualifying disabilities, or end-stage renal disease (ESRD), with distinct parts A, B, and D

First Report of Injury

A form filed for Workers' Compensation claims, detailing the patient's information, accident description, and treatment plan

CHAMPVA

A health care program for spouses or children of veterans who are permanently and totally disabled, or families of deceased veterans, covering care at military health care facilities

Medicare Advantage

A managed care plan administered by a private insurer, typically including Parts A, B, and D

TRICARE

A military medical care program for active-duty and retired service members, their families, and Medal of Honor recipients

Progress Report

A report filed for Workers' Compensation claims, describing the patient's care and any significant changes in medical or disability status

Pre-authorization

A requirement in most states for approval before certain medical services can be provided under Medicaid

Medicaid

A state-administered medical assistance program for the poor and medically indigent, with benefits including inpatient and outpatient hospital services, physician services, and more

Participating Provider

Agrees to write off the difference between the Medicare-approved amount and the standard charge

Non-participating Provider

Can pass the additional cost of non-allowed amounts to the patient

Workers' Compensation

Coverage for work-related illnesses or injuries, required by federal and state laws, providing wage replacement and medical benefits

Medicare Part A

Covers inpatient hospital care, skilled nursing facilities, hospice care, and some home health care, with no monthly premium but annual deductibles

Medicare Part D

Covers part of the cost for prescription drugs, with a monthly premium based on income

Medicaid Eligibility Certificate

Documentation required to verify a patient's monthly eligibility for Medicaid benefits

Medicare Part B

Pays for doctors' services, outpatient hospital care, durable medical equipment, and some medical services not covered by Part A, with a monthly premium and annual deductible


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