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A National Provider Identifier ( NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...
Resource-based relative value scale. Resource-based relative value scale ( RBRVS) is a schema used to determine how much money medical providers should be paid. It is partially used by Medicare in the United States and by nearly all health maintenance organizations (HMOs). RBRVS assigns procedures performed by a physician or other medical ...
Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 85 million low-income and disabled people as of 2022; [ 3] in 2019, the program paid for half of all U.S. births. [ 4]
Early and Periodic Screening, Diagnostic and Treatment ( EPSDT) is the child health component of Medicaid. Federal statutes and regulations state that children under age 21 who are enrolled in Medicaid are entitled to EPSDT benefits and that States must cover a broad array of preventive and treatment services. Unlike private insurance, EPSDT is ...
The Federally Facilitated Marketplace (FFM) is an organized marketplace for health insurance plans operated by the U.S. Department of Health and Human Services (HHS). The FFM opened for enrollments starting October 1, 2013. [ 1] The Federally Facilitated Marketplace is established in a state by the HHS Secretary for states that chose not to set ...
The Colorado Department of Health Care Policy and Financing ( HCPF) is the principal department of the Colorado state government [2] responsible for administering the Health First Colorado ( Medicaid) and Child Health Plan Plus programs as well as a variety of other programs for Colorado's low-income families, the elderly, and persons with ...
In the United States, health insurance marketplaces, [1] also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection and Affordable Care Act (ACA, known colloquially as "Obamacare") at ACA health exchanges, where ...
It is jointly managed and financed by the federal government and the states. More than 70 million Americans are enrolled in Medicaid or the Children’s Health Insurance Program, a related benefit. Medicaid mainly covers children, pregnant women, some parents of poor kids, people with disabilities and elderly nursing home patients.