Medicare patient definition

Medicare patient means a patient who is an eligible person for the purpose of receiving medical benefits under the Health Insurance Act 1973 of the Commonwealth;
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Medicare patient defined. “Medicare patient” means a patient for whom a payment is received directly by a hospital from a program of insurance for Medicare. The term includes a patient for whom a payment is received by the hospital pursuant to a program of insurance for Medicare for a health maintenance organization.
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Examples of Medicare patient in a sentence

  • A group practice must report on at least 1 measure for which there is Medicare patient data.

  • An eligible professional must report on at least 1 measure for which there is Medicare patient data.

  • A group practice must re- port on at least 1 measure for which there is Medicare patient data.

  • Of the 9 measures re- ported, if the eligible professional sees at least 1 Medicare patient in a face-to- face encounter, the eligible profes- sional must report on at least 1 meas- ure contained in the cross-cutting measure set specified by CMS.

  • A group prac- tice must report on at least 1 measure for which there is Medicare patient data.

  • An eligible pro- fessional must report on at least 1 measure for which there is Medicare patient data.

  • The product derived in step one is multiplied by the hospital’s Medicare patient load.

  • In keeping with our policy on discharges, these case-mix index values are computed based on all Medicare patient discharges subject to DRG-based payment.

  • If a group practice’s CEHRT does not contain patient data for at least 9 measures covering at least 3 do- mains, then the group practice must report the measures for which there is Medicare patient data.

  • If a group practice’s CEHRT does not con- tain patient data for at least 9 meas- ures covering at least 3 domains, then the group practice must report the measures for which there is Medicare patient data.

Related to Medicare patient

  • Hospice patient s family" means a hospice patient's immediate family members, including a spouse, brother, sister, child, or parent, and any other relative or individual who has significant personal ties to the patient and who is designated as a member of the patient's family by mutual agreement of the patient, the relative or individual, and the patient's interdisciplinary team.

  • Medicare Provider Agreement means an agreement entered into between CMS or other such entity administering the Medicare program on behalf of CMS, and a health care provider or supplier under which the health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Medicare means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.

  • Medicaid means that government-sponsored entitlement program under Title XIX, P.L. 89-97 of the Social Security Act, which provides federal grants to states for medical assistance based on specific eligibility criteria, as set forth on Section 1396, et seq. of Title 42 of the United States Code.

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Health care practitioner means an individual licensed

  • Medicare benefit means the Medicare benefit payable within the meaning of Part II of the Health Insurance Act 1973 with respect to a professional service.

  • Respiratory care practitioner means an individual who practices respiratory care.

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • In-patient means a person admitted to a hospital as a resident or bed- patient and who is provided at least one day's room and board by the hospital.

  • Acute care hospital means a Hospital that provides Acute Care Services. Adjudicate means to deny or pay a Clean Claim. Administrative Services see MCO Administrative Services. Administrative Services Contractor see HHSC Administrative Services Contractor.

  • Licensed health care professional means a person who possesses a professional medical license that is valid in Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner (NP), licensed practical nurse (LPN), medical doctor (MD), osteopathic physician (DO), respiratory therapist (RT), physical therapist (PT), physician assistant (PA), or occupational therapist (OT).

  • TRICARE means, collectively, a program of medical benefits covering former and active members of the uniformed services and certain of their dependents, financed and administered by the United States Departments of Defense, Health and Human Services and Transportation, and all laws applicable to such programs.

  • Day Patient means an Insured Person receiving Medical Services or treatments given in a medical clinic, day case procedure centre or Hospital where the Insured Person is not in Confinement.

  • Health care provider or "provider" means:

  • Health care system means any public or private entity whose function or purpose is the management of, processing of, enrollment of individuals for or payment for, in full or in part, health care services or health care data or health care information for its participants;

  • Health Care Operations shall have the meaning given to such term under the HIPAA 2 Privacy Rule in 45 CFR § 164.501.

  • Primary care physician means a physician qualified to be an attending physician according to ORS 656.005(12)(b)(A) and who is a general practitioner, family practitioner, or internal medicine practitioner.

  • Health Care Law means any Applicable Law regulating the acquisition, construction, operation, maintenance or management of a health care practice, facility, provider or payor, including without limitation, 42 U.S.C. ss.1395nn and 42 U.S.C. ss. 1320a-7b.

  • Patient means a person who is undergoing medical or other treatment as an in-patient in any hospital or similar institution;

  • Health care professional means a physician or other health care practitioner licensed, accredited or certified to perform specified health care services consistent with state law.

  • Health care coverage means any plan providing hospital, medical or surgical care coverage for

  • Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.

  • Nursing home-type patients means a patient who has been in hospital more than 35 days, no longer requires acute hospital care, cannot live independently at home or be looked after at home, and either cannot be placed in a nursing home or a nursing home place is not available.