Examlex
All the following are true of compensable factors except:
Participating Provider
A healthcare provider who has agreed to accept predetermined fees for services provided to members of a specific insurance plan or network.
Insurer
An entity that provides insurance coverage to individuals or organizations, assuming the risk for specified losses.
Patient-Centered Medical Home (PCMH)
A health care delivery model designed to provide comprehensive, coordinated, and continuous care to patients with the goal of optimizing health outcomes.
Advance Beneficiary Notice (ABN)
Document used to notify a Medicare beneficiary that it is either unlikely that Medicare will pay or certain that Medicare will not pay for the service they are going to be provided. Beneficiaries are required to sign this document if they wish to have the service with the understanding that they will be responsible for payment.
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