Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis. It was begun in 1965 under the Social Security Administration and is now administered by the Centers for Medicare and Medicaid Services (CMS).
Erotic massage is the use of massage techniques by one person on another person's erogenous zones for their sexual pleasure. The process may achieve or enhance the recipient's sexual excitation or arousal and sometimes achieve orgasm. The person providing the massage is called a masseur (male) or masseuse (female). Massages have been used for medical purposes for a very long time, and their use for erotic purposes also has a long history. In the case of women, the two focal areas are the abdomens and pubis, while in case of men, the focal areas are the male breast muscles and nipples, male genitals, the anus, and the prostate. When the massage is of a partner's genitals, the act is usually referred to as a handjob for penises and fingering for vulvas.
The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It encompasses the creation and commercialization of products and services conducive to the preservation and restoration of well-being. The contemporary healthcare sector comprises three fundamental facets, namely services, products, and finance. It can be further subdivided into numerous sectors and categories and relies on interdisciplinary teams of highly skilled professionals and paraprofessionals to address the healthcare requirements of both individuals and communities.
Medical billing is a payment practice within the United States healthcare system. The process involves the systematic submission and processing of healthcare claims for reimbursement. Once the services are provided, the healthcare provider creates a detailed record of the patient's visit, including the diagnoses, procedures performed, and any medications prescribed. This information is translated into standardized codes using the appropriate coding system, such as ICD-10-CM or Current Procedural Terminology codes—this part of the process is known as medical coding. These coded records are submitted by medical billing to the health insurance company or the payer, along with the patient's demographic and insurance information. Most insurance companies use a similar process, whether they are private companies or government sponsored programs. The insurance company reviews the claim, verifying the medical necessity and coverage eligibility based on the patient's insurance plan. If the claim is approved, the insurance company processes the payment, either directly to the healthcare provider or as a reimbursement to the patient. The healthcare provider may need to following up on and appealing claims.
Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician has a financial relationship with that entity.
Primaris is a health care consulting company in Columbia, Missouri. Primaris has held the Medicare Quality Improvement Organizations contract for Missouri since the program was created.
Health care prices in the United States of America describe market and non-market factors that determine pricing, along with possible causes as to why prices are higher than in other countries.
Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately.
Case management is a managed care technique within the health care coverage system of the United States. It involves an integrated system that manages the delivery of comprehensive healthcare services for enrolled patients. Case managers are employed in almost every aspect of health care and these employ different approaches in the control of clinical actions.
In the US a certificate of medical necessity is a document required by Centers for Medicare and Medicaid Services to substantiate in detail the medical necessity of an item of durable medical equipment or a service to a Medicare beneficiary. There are different types of CMN for different requirements, e.g., insulin pumps, home health and private duty nursing services, etc.
Durable medical equipment is any medical equipment used in the home to aid in a better quality of living. It is a benefit included in many insurance policies and in some cases covered by Medicare benefits. The item is defined by Title XIX for Medicaid:
This article discusses the definitions and types of home medical equipment (HME), also known as durable medical equipment (DME), and durable medical equipment and prosthetics and orthotics (DMEPOS).
In the United States, Medicare fraud is the claiming of Medicare health care reimbursement to which the claimant is not entitled. There are many different types of Medicare fraud, all of which have the same goal: to collect money from the Medicare program illegitimately.
First Databank (FDB) is a major provider of drug and medical device databases that help inform healthcare professionals to make decisions. FDB partners with information system developers to deliver useful medication- and medical device-related information to clinicians, business associates, and patients. FDB is part of Hearst and the Hearst Health network.
Patient portals are healthcare-related online applications that allow patients to interact and communicate with their healthcare providers, such as physicians and hospitals. Typically, portal services are available on the Internet at all hours of the day and night. Some patient portal applications exist as stand-alone web sites and sell their services to healthcare providers. Other portal applications are integrated into the existing web site of a healthcare provider. Still others are modules added onto an existing electronic medical record (EMR) system. What all of these services share is the ability of patients to interact with their medical information via the Internet. Currently, the lines between an EMR, a personal health record, and a patient portal are blurring. For example, Intuit Health and Microsoft HealthVault describe themselves as personal health records (PHRs), but they can interface with EMRs and communicate through the Continuity of Care Record standard, displaying patient data on the Internet so it can be viewed through a patient portal.
The Compliance Team (TCT) Inc., is a US for-profit organization that provides Exemplary Provider accreditation and certification services to healthcare providers across the United States. It was set up in 1994 and is based in Philadelphia, Pennsylvania.
A standing wheelchair is assistive technology, similar to a standing frame, that allows a wheelchair user to raise the chair from a seated to a standing position. The standing wheelchair supports the person in a standing position and enables interaction with people and objects at eye level.
In the United States, hospice care is a type and philosophy of end-of-life care which focuses on the palliation of a terminally ill patient's symptoms. These symptoms can be physical, emotional, spiritual, or social in nature. The concept of hospice as a place to treat the incurably ill has been evolving since the 11th century. Hospice care was introduced to the United States in the 1970s in response to the work of Cicely Saunders in the United Kingdom. This part of health care has expanded as people face a variety of issues with terminal illness. In the United States, it is distinguished by extensive use of volunteers and a greater emphasis on the patient's psychological needs in coming to terms with dying.
Healthgrades Marketplace, LLC, known as Healthgrades, is a US company that provides information about physicians, hospitals, and healthcare providers. Healthgrades is part of RVO Health, a partnership between Red Ventures and Optum, part of UnitedHealth Group. Healthgrades has amassed information on over three million U.S. health care providers. The company was founded by Kerry Hicks, David Hicks, Peter Fatianow, John Neal, and Sarah Lochran, and is based in Denver, Colorado. Jeff Hallock serves as RVO Health's CEO. According to USA Today, Healthgrades is the first comprehensive physician rating and comparison database. The application is part of a trend in health technology in the United States towards consumer-driven healthcare.
Credentialing is the process of establishing the qualifications of licensed medical professionals and assessing their background and legitimacy.
