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Medicare

A federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).

Off-campus outpatient department of a provider

A hospital-owned clinic or facility that is located physically away from the main hospital campus but provides outpatient services, such as doctor's visits or diagnostic tests.

Site-neutral payments

A policy where the payment amount for a specific healthcare service is the same regardless of the type or location of the facility where it's provided (e.g., whether it's in a hospital, a hospital-owned clinic, or an independent clinic).

NPI (National Provider Identifier)

A unique 10-digit identification number issued to healthcare providers in the United States by the Centers for Medicare & Medicaid Services (CMS). It's used for administrative and financial transactions like billing.

HIPAA X12 837P transaction

An electronic format used by healthcare providers to submit professional medical claims to insurance companies for payment, adhering to Health Insurance Portability and Accountability Act (HIPAA) standards.

CMS 1500 form

A paper form used by healthcare providers to bill Medicare and other insurance companies for outpatient medical services and supplies.