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The National Correct Coding Initiative (NCCI) is a Centers for Medicare & Medicaid Services (CMS) program designed to prevent improper payment of procedures that should not be submitted together. There are two categories of edits:
The PMAG is composed of performance measurement experts representing the Agency for Healthcare Research and Quality (AHRQ), the American Medical Association (AMA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA ...
Medicare Prescription Drug, Improvement, and Modernization Act; Long title: An act to amend title XVIII of the Social Security Act to provide for a voluntary prescription drug benefit under the medicare program and to strengthen and improve the medicare program, and for other purposes. Acronyms (colloquial) Medicare Modernization Act or MMA ...
An 834 file contains a string of data elements, with each representing a fact, such as a subscriber’s name, hire date, etc. The entire string is called a transaction set. The 834 is used to transfer enrollment information from the sponsor of the insurance coverage, benefits, or policy to a payer.
The latest edition supported by this template is the 2012 Guidelines Manual, effective as of November 1, 2012. Optionally, the year of a previous edition may be specified instead, when one wants to cite the Sentencing Guidelines that were in effect on a given date. Each year's edition becomes effective on November 1 st of the specified year.
The term template, when used in the context of word processing software, refers to a sample document that has already some details in place; those can (that is added/completed, removed or changed, differently from a fill-in-the-blank of the approach as in a form) either by hand or through an automated iterative process, such as with a software assistant.
For example, the word processing application Microsoft Word uses different file extensions for documents and templates: In Word 2003 the file extension .dot is used to indicate a template, in contrast to .doc for a standard document. In Word 2007 and later versions, it's .dotx, instead of .docx for documents. The OpenDocument Format also has ...
An electronic remittance advice (ERA) is an electronic data interchange (EDI) version of a medical insurance payment explanation.It provides details about providers' claims payment, and if the claims are denied, it would then contain the required explanations.