Medicaid is a health insurance program for low-income individuals and families that cannot afford healthcare costs.
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Created by Rynzelle Spraggs
about 6 years ago
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Close
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Created by Rynzelle Spraggs
about 6 years ago
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MEDICAID
MEDICAID ELIGIBILITY
MEDICAID BENEFITS
Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
Prior Authorization
Medicaid Claims Filing Requirements
Medicaid Claims Completion Guidelines
Common Denials for Medicaid Claims
Medigap
Medigap Claims Processing
Cross-over
Medigap Transfer
EOMB
COBRA
TRICARE (FORMERLY CHAMPUS)
CHAMPVA
(THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS)
DEPARTMENT OF DEFENSE DEFINITION OF CASE MANAGEMENT
TRICARE Prime
TRICARE Extra
TRICARE Standard
CHAMPVA
Beneficiary Counseling and Assistance Coordinators (BCACs)
CAC
DBN
DoD ID
COMMON DENIALS FOR TRICARE
TRICARE Appeals
Common Reasons for a TRICARE claim review
Which charges are denied through TRICARE
What should be included on the TRICARE appeal
RBRVS/RVU Concepts
RVU
GAF (GPCI)
Status Codes
Status Code A
Status Code B
Status Code C
Status Code E
Status Code I
Status Code M
Status Code N
Status Code P
Status Code Q
Status Code R
Status Code T
Status Code X
PC/TC Indicator
PC/TC Indicator 0
PC/TC Indicator 1
PC/TC Indicator 2
PC/TC Indicator 3
PC/TC Indicator 4
PC/TC Indicator 5
PC/TC Indicator 6
PC/TC Indicator 7
PC/TC Indicator 8
PC/TC Indicator 9
Global Surgery Indicators
Global Surgery Indicators 000
Global Surgery Indicators 010
Global Surgery Indicators 090
Global Surgery Indicators MMM
Global Surgery Indicators XXX
Global Surgery Indicators YYY
Global Surgery Indicators ZZZ
Three fields following the global surgery days field breakdown
Multiple procedure
Multiple procedure 0
Multiple procedure 1
Multiple procedure 2
DEERS
DoD Benefits Number (DBN)
DoD ID number
Two types of TRICARE providers
Multiple procedure 3
Multiple Procedure 4
Multiple Procedure 5
Multiple Procedure
The Clinical Prior
Authorization Program
Multiple Procedure 6
Multiple Procedure 7
Technical Component 9
Bilateral surgery
Bilateral surgery 0
Medigap
Bilateral surgery 1
Bilateral surgery 2
Bilateral surgery 3
Bilateral surgery 9
Assistant at Surgery
Assistant at Surgery 0
Assistant at Surgery 1
Assistant at Surgery 2
Assistant at Surgery 9
Co-surgeons
Co-surgeons 0
Co-surgeons 1
Co-surgeons 2
Co-surgeons 9
Team Surgery
Team surgeons 0
Team surgeons 1
Team surgeons 2
Team surgeons 9
Endoscopic base code field
Accept Assignment
Advance Beneficiary Notice
Civilian Health and Medical Program of tf the Department of Veteran Affairs
CHAMPVA
Crossover Claim
Early and Periodic Screening, Diagnostic and Treatment (EPSDT)
Medigap
National Provider Identifier (NPI)
Non-Participating Provider
Participating Provider
Relative Value Unit
Resourced Based Relative Value System
TRICARE
Medicare Eligibility
Medicare Parts
Medicare -- Contractual Options
