Glossary of Health Care and Medical Terms

In many cases,
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see Medicare Advantage
Also see: Medicare Advantage

MAC

Medicare Administrative Contractors

MAGI: Modified adjusted gross income, which is used to determine eligibility for insurance affordability programs under the ACA. With MAGI, federal individual income tax rules determine net income and household composition.

Management Science: The school of management emphasizing the use of mathematics and statistics as an aid in resolving production and operations problems

Medical Assistance Provider Incentive Repository (MAPIR) is the state-level information system for the Medicaid Electronic Health Record (EHR) Incentive Program. MAPIR will track information regarding registration, attestation and payments and provide program oversight. As of June 26, 2012, Eligible professionals (EPs) and Eligible hospitals (EHs) must use MAPIR system to register and attest to the Meaningful Use measures for a 90-day period in the second year of participation.

MAR

A Medication Administration Record (MAR or eMAR for electronic versions) is the report that serves as a legal record of the drugs administered to a patient at a facility by a health care professional. Also called a Drug chart.
Also see: Medication Administration Record

Major Complications and Comorbidities

Medicare Care Management Performance Demonstration

MDM

Medical Decision-Making (MDM) is one of the three key components of E&M. It involves making a diagnosis and selecting an appropriate treatment.

MDS

Minumum Data Set (Used for long term care)

Meaningful Use are criteria for use of HITECH Act electronic health record technology set by the Center for Medicare & Medicaid Services / CMS.
Also see: MU

Medicaid - 1) A state/federal benefit program for the poor who are aged, blind, disabled, or members of families with dependent children. Each state sets its own eligibility standards. Only 40 percent of individuals with income below the poverty level currently are covered.

see Claims Adjudication
Also see: Claims Adjudication

Patient-Centered Medical Home
Also see: Patient-Centered Medical Home

See Health informatics
Also see: Biomedical Informatics, Health Informatics, Healthcare Informatics, Nursing Informatics

Medical Loss Ratio (or MLR) is the amount of health insurance premiums that an insurer spends on health care and activities to improve health care quality. Under the Medical Loss Ratio provision of the Affordable Care Act, insurance companies are required to spend 80 percent (individual and small group markets) or 85 percent (large group markets) of premium dollars on medical care and health care quality improvement, rather than on administrative costs.
Also see: MLR

Medicare - A federal health benefit program for people over 65 and disabled and disabled that covers 35 million Americans - or about 14 percent of the population - for an annual cost of over $120 billion. Medicare pays for 25 percent of all hospital care and 23 percent of all physician services.

Medicare Advantage Plans, sometimes called "Medicare+Choice",
Also see: Medicare, Medicare Part C

In 2003, Congress amended the federal Medicare Act, confirming that when a personal injury plaintiff receives Medicare benefits for treatment of his or her injuries, Medicare’s right to recover those payments trumps everybody else’s rights. Thus, under the amendments, Medicare can get its money from either the plaintiff or the settling defendants, even when those defendants have already paid the plaintiff.

Part A Medicare - Medical Hospital Insurance (HI) under Part A of Title XVIII of Social Security Act, which covers patients for inpatient hospital, home health, hospice, and limited skilled nursing facility services. Beneficiaries are responsible for deductibles and co-payments.
Also see: Medicare

Part B Medicare - Medicare Supplement Medical Insurance (SMI) under Part B of Title XVII of the Social ecurity Act, which covers Medicare beneficiaries for physician services, medical supplies, and other outpatient treatment. Beneficiaries are responsible for monthly premiums, co-payments, deductibles, and balance billing.
Also see: Medicare

see Medicare Advantage
Also see: Medicare

Medicare Physician Fee Schedule (MPFS) is a system whereby Medicare pays for covered physicians. It provides more than 10,000 physician services, the associated relative value units, a fee schedule status indicator and various payment policy indicators needed for payment adjustment.
Also see: MPFS

A Medicare Private Fee-for-Service Plan is a Medicare Advantage Plan offered by a private insurance company. In a Medicare Private Fee-for-Service Plan, Medicare pays a set amount of money every month to the private insurance company to provide health care coverage. Medicare Private Fee-for-Service Plans must cover all medically-necessary services covered by Medicare Part A and Part B. It is not the same as a Medigap (Medicare Supplement Insurance) policy, Medicare SELECT, or Medicare Prescription Drug Plan.
Also see: Medicare, Medicare Advantage, FFS

see Medicare Advantage
Also see: Medicare

Drug Chart
Also see: MAR

Active Medication Allergy List

Medication Reconciliation -- The process of identifying the most accurate list of all medications that the patient is taking, including name, dosage, frequency and route by comparing the medical record to an external list of medications obtained from a patient, hospital or or other provider

Medigap Insurance is privately purchased individual or group health insurance policies designed to supplement Medicare coverage. Benefits may include payment of Medicare deductibles, co-insurance and balance bills, as well as payment for services not covered by Medicare.

Medicare Provider Analysis and Review File. The MedPAR File contains inpatient hospital and skilled nursing facility (SNF) final action stay records. Each MedPAR record represents a stay in an inpatient hospital or SNF.

MEI

Medicare Economic Indes (MEI)

Medicare Geographic Classification Review Board (MGCRB)

Medical Group Management Association

Medicare Improvements and Extension Act, Division B of the Tax Relief and Health Care Act (MIEA-TRHCA) of 2006, Public Law 109-432

Million Hearts

Medicare Information Patient Provider Act (MIPPA) of 2008 established incentives for eligible providers who are successfully e-prescribing (i.e. electronic e-prescribers)

Multi-Level Healthcare Information Modelling (MLHIM) brings semantic interoperability to Healthcare IT.

The Multi-Level Healthcare Information Modeling  specifications are partially derived from ISO Healthcare Information Standards and the openEHR 1.0.2 specifications. The version 2.3.0 of the MLHIM specifications introduces modernization through the use of XML technologies.

Managing Lead Partner Council - FHA

MLR

Medical Loss Ratio (MLR)

 

Medicare Modernization Act (MMA) passed in 2003 began encouraging doctors to e-prescribe

Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) is a federal law. Section 111 requires reporting of liability insurance (including self-insurance), no-fault insurance and workers’ compensation in situations where the injured person is Medicare-entitled. This mandatory quarterly electronic claims reporting (for non-group health claims)

MOC

Maintenance of Certification (MOC) program
Also see: MOCP

Maintenance of Certification Program (MOCP) qualifies PQRS eligible providers to receive an additional 0.5% incentive payment.

Medicare Physician Fee Schedule (MPFS)
Also see: Medicare Physician Fee Schedule

Multiple Procedure Payment Reduction (MPPR)

Medicare Severity Diagnosis Related Group (MS-DRG). Medicare reimbursement code assigned at admission that allows hospital to get paid for related ailments after patient is discharge.It excludes hospital acquired condictions. The DRG system classifies payments into groups based on the principal diagnosis, type of surgical procedure, presences or absence of complications, and other relevant indicators.
Also see: DRG

Medicare severity long-term care diagnosis-related group (MS-LTC-DRG)
Also see: DRG

Medical Service Organization

Medical Transcription Industry Association

Medical Transcription Service Organization

MU

Meaningful Use
Also see: Meaningful Use

Medically Underserved Areas. See HPSA
Also see: HPSA, MUP

Massachusetts General Hospital Utility Multiprogramming System (MUMPS) developed in 1960 is a programming language used by medical systems such as Costar and Veterans Administration Hospital System (VISTA).

MUP

Medically Underserved Populations. See HPSA
Also see: HPSA, MUA

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