Find definitions for common terms in Medicare and Medicaid data sets.
Term
Definition
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admission date
"The date the patient was admitted for inpatient care, outpatient service, or start of care" (CMS Glossary).
For hospice care, the date that the patient effectively elected hospice services.
assessment
The collection of both self-reported and provider-reported health status, using a form.
beneficiary
A person who receives healthcare insurance through the Medicare or Medicaid program.
Beneficiary Identifier (BID)
A random and unique number assigned to each beneficiary.
carrier
"A private company that has a contract with Medicare to pay...Medicare Part B bills" (CMS Glossary).
claim
A bill submitted to health insurance carriers or providers for patient services performed by a healthcare provider.
coinsurance
The amount (usually a fixed percentage) that the beneficiary must pay for healthcare services, after paying any plan-related deductible.
copay
"A fixed amount established by an insurance plan for sharing the cost of certain health services between the insurance plan and the insurance customer" (Healthcare.Gov Glossary).
crosswalk file
A file that maps the MedRIC's Beneficiary Identifier (BID) to a survey's identifiers, enabling you to link CMS data to survey data.
data type
In the context of Centers for Medicare & Medicaid Services (CMS) data, the different categories ('types') of CMS data (such as Parts A & B, Part D Drug Event (PDE), and Medicaid Analytic Extract (MAX)).
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