Search results
Results from the WOW.Com Content Network
Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status.
Medicaid is a program is designed to assist families with limited income and resources. Medicaid covers various medical services, including hospitalization, doctor's visits and nursing home care.
Currently, managed care is the most common health care delivery system in Medicaid. In 2007, nearly two-thirds of all Medicaid beneficiaries are enrolled in some form of managed care – mostly, traditional health maintenance organizations (HMO) and primary care case management (PCCM) arrangements.
Continuity of Care Document - The Continuity of Care Document (CCD) represents a core data set of the most relevant administrative, demographic, and clinical information facts about a patient's healthcare, covering one or more healthcare encounters. The primary use case for the CCD is to provide a snapshot in time containing the germane ...
Since then, HEW, has been reorganized as the Department of Health and Human Services (HHS) in 1980. This consequently brought Medicare and Medicaid under the jurisdiction of the HHS. [8] In March 1977, the Health Care Financing Administration (HCFA) was established under HEW. [9] HCFA became responsible for the coordination of Medicare and ...
The Centers for Medicare and Medicaid Services has issued regulations regarding seclusion and restraint. These regulations are called "Conditions of Participation (CoPs)." CoPs serve as the basis of survey activities for the purpose of determining whether a facility qualifies for a provider agreement under Medicare or Medicaid.
Home and Community-Based Services waivers (HCBS waivers) or Section 1915(c) waivers, 42 U.S.C. Ch. 7, § 1396n §§ 1915(c), are a type of Medicaid waiver. HCBS waivers expand the types of settings in which people can receive comprehensive long-term care under Medicaid.
The social safety net refers to those providers that organize and deliver a significant level of health care and other needed services to the uninsured, Medicaid, and other vulnerable patients. [15] This is important given that the uninsured rate for Americans is still high after the advent of the Affordable Care Act, with a rate of 10.9%, or ...