Government Insurance Programs
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
