This glossary contains key terms and definitions related to all coursework in healthcare skills, clinical and non-clinical, and also general compliance and regulatory issues affecting healthcare.
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Continuous activity that requires the use of increased oxygen to
maintain the function of the body’s cells.
Affiliated Contractors (ACs) & Medicare Administrative Contractors (MACs)
Medicare claims processing
contractors such as carriers and fiscal intermediaries (FIs).
They process claims submitted by physicians, hospitals,
and other health care providers/suppliers, and submit
payment to those providers in accordance with Medicare
rules and regulations. This includes identifying and
correcting underpayments and overpayments. An AC
or a MAC Medical Review (MR) can be a prepayment
or postpayment claim review.
Agency for Healthcare Research and Quality (AHRQ)
The Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with improving the safety and quality of America's health care system. AHRQ develops the knowledge, tools, and data needed to improve the health care system and help Americans, health care professionals, and policymakers make informed health decisions.
Protein produced by immune cells to fight infection.
Beneficence means that healthcare providers have a duty to do
good, act in the best interest of their patients, and act in the best interest
of society as a whole.
Bloodborne Pathogens (OSHA Standard)
OSHA issued this standard to protect employees from the health hazards of exposure to bloodborne pathogens. Employers are subject to OSHA's Bloodborne Pathogens standard if they have employees whose jobs put them at reasonable risk of coming into contact with blood or other potentially infectious materials. Employers subject to this standard must develop a written exposure control plan, provide training to exposed employees, and comply with other requirements of the standard.
Care Coordination and Care Transitions is one of the six key PCMH concepts. It ensures that primary and specialty care clinicians are effectively sharing information and managing patient referrals to minimize cost, confusion and inappropriate care. It helps eliminate repetitive tests and streamline referral processes.
Care Management and Support is one of the six key PCMH concepts. It helps clinicians set up care management protocols to identify patients who need more closely-managed care. This might include populations at high risk or patients with chronic diseases. Care management is a broad idea which also includes specific PCMH activities such as Care Coordination and Patient Population Management.
Center for Medicare and Medicaid Services (CMS)
Previously known as the Health Care Financing
Administration (HCFA), CMS is a federal agency within the
United States Department of Health and Human Services
(DHHS) that administers the Medicare program and
works in partnership with state governments to administer
Medicaid, the State Children’s Health Insurance Program
(SCHIP), and health insurance portability standards.
Centers for Disease Control and Prevention (CDC)
The Centers for Disease Control and Prevention is the leading national public health institute of the United States. The CDC is a United States federal agency under the Department of Health and Human Services.