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Essay / Research Paper Abstract
This 4-page paper provides definitions to many abbreviations seen in conjunction with medical insurance terminology. Definitions include Current Procedural Terminology (CPT), Adjusted Mortality Ratios (AMR) and Diagnoses Related Group (DRG). Bibliography lists 2 sources.
Page Count:
4 pages (~225 words per page)
File: D0_MTmedinste.rtf
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Unformatted sample text from the term paper:
has to live. For example, the AMR for older men who smoke too much and drink is going to be pretty high; higher than teen-age girls who dont smoke and
who watch their weight. Most insurance companies use AMR to underwrite (or deny) coverage. Some believe this is patently unfair, as trying to lump people together into one category (and
assuming someone is going to die) doesnt seem equitable. CMR. Comprehensive Medical Reviews lets the Medicare/Medicaid people know if
a particular medical group is providing medically unnecessary, non-covered services. CMRs are typically triggered if a provider is showing questionable billing patterns. Most times, the CMR is conducted on site,
at the providers offices. CMS. Centers for Medicare and Medicaid Services is part of the United States Department of
Health and Human Services. This is the department that is in charge of the Medicare programs. The CMS also oversees and administers Medicaid and the State Childrens Health Insurance Program.
CMS is also involved in legislative affairs. CMS-1500. The CMS-1500 is the standard claim form used by a service
provider (non-institutional) to bill Medicare carriers. The CMS-1500 is also sometimes used to bill certain Medicaid state agencies. Not just any old form will do, however - these forms need
to be ordered from the U.S. Government Printing office (or can be ordered through local supply stores). They need to be printed in exact match ink, as scanning technology is
used to process the forms. CPT. Current Procedural Terminology is the backbone of insurance reporting, but its also one of
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