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  2. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. As outlined in ...

  3. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    HCFA was renamed the Centers for Medicare and Medicaid Services on July 1, 2001. [8] [10] In 2013, a report by the inspector general found that CMS had paid $23 million in benefits to deceased beneficiaries in 2011. [11] In April 2014, CMS released raw claims data from 2012 that gave a look into what types of doctors billed Medicare the most. [12]

  4. Unique physician identification number - Wikipedia

    en.wikipedia.org/wiki/Unique_physician...

    A unique physician identification number (UPIN) was a six-character alpha-numeric identifier used by Medicare to identify doctors in the United States. They were discontinued in June 2007 [1] and replaced by National Provider Identifier, or NPI numbers. [why?] The United States Congress authorized the creation of UPIN IDs through Section 9202 ...

  5. National coverage determination - Wikipedia

    en.wikipedia.org/wiki/National_coverage...

    National coverage determination. A national coverage determination (NCD) [1] is a United States nationwide determination of whether Medicare will pay for an item or service. [2] It is a form of utilization management and forms a medical guideline on treatment. Medicare coverage is limited to items and services that are considered "reasonable ...

  6. Medicare (United States) - Wikipedia

    en.wikipedia.org/wiki/Medicare_(United_States)

    Medicare (United States) 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 (ALS or Lou Gehrig's disease). It was begun in 1965 under the Social Security Administration and is now ...

  7. Federally Qualified Health Center - Wikipedia

    en.wikipedia.org/wiki/Federally_Qualified_Health...

    President Bush launched the Health Centers Initiative to significantly increase access to primary health care services in 1,200 communities through new or expanded health center sites. Between 2001 and 2006, the number of patients treated at health centers increased by over 4.7 million, representing a nearly 50 percent increase in just five years.

  8. Physician Quality Reporting System - Wikipedia

    en.wikipedia.org/wiki/Physician_Quality...

    As of 2015, CMS included the following health care practitioners under eligible providers: [4] Medicare providers (Physicians (Doctors of Medicine, Osteopathic Medicine), Podiatry, Optometry, Oral Surgery, Dentistry, and Chiropractic)

  9. Preferred provider organization - Wikipedia

    en.wikipedia.org/wiki/Preferred_provider...

    A preferred provider organization is a subscription-based medical care arrangement. [1] A membership allows a substantial discount below the regularly charged rates of the designated professionals partnered with the organization. Preferred provider organizations themselves earn money by charging an access fee to the insurance company for the ...