Understand healthcare terms, Medicare concepts, and medical jargon with our comprehensive glossary.
Scheduling, appointments, and care coordination
Medical billing, claims, and reimbursement terms
General healthcare and medical terms
Patient advocacy and navigation terms
Insurance and coverage terminology
Health conditions and treatment terms
Fundamental Medicare concepts and terminology
What Are Ability-to-Pay Programs? Ability-to-Pay Programs, often called Financial Assistance or Charity Care Programs, are initiatives offered by ho...
What Is an Accountable Care Organization (ACO)? An Accountable Care Organization (ACO) is a network of doctors, hospitals, and other providers who p...
What Are Activities of Daily Living (ADLs)? Activities of Daily Living (ADLs) are the fundamental self-care tasks required to manage one's basic phy...
What Are Administrative Simplification Provisions? These are a set of rules under the Health Insurance Portability and Accountability Act (HIPAA) th...
What Is Advance Care Planning? Advance Care Planning is the process of preparing for future healthcare decisions in the event you cannot speak for y...
What Is an Advance Directive? An advance directive is the legal document that formalizes your wishes from advance care planning. It is your written ...
What Are Alternative Medicine Approaches? Alternative medicine refers to non-conventional treatments and therapies used either alongside or in place...
What Is Ambulatory Care? Ambulatory care is any medical service you receive without being admitted to a hospital. It's also known as outpatient care...
What Is an Anatomical Gift Declaration? An anatomical gift declaration is a legal document stating your wish to donate your organs, tissues, or enti...
What Is an Annual Out-of-Pocket Maximum? Your annual out-of-pocket maximum is a financial safety net. It's the absolute most you will have to pay fo...
What Is an Asset Spend-Down? Asset spend-down is the process of reducing your financial assets to meet the strict eligibility limits for Medicaid lo...
Assisted Living vs. Nursing Home: What’s the Difference? Assisted living is for those who need help with daily activities but are still largely inde...
What Is Balance Billing? Balance billing occurs when a provider bills you for the difference between their full charge and the [allowed amount](/glo...
What Are Behavioral Health Services? Behavioral health services encompass all treatments for mental health conditions (like depression and anxiety),...
What Is a Beneficiary? A beneficiary is the person entitled to receive benefits from an insurance plan or government program. If you have Medicare, ...
What Is a Benefit Period? A benefit period is a specific term used by Medicare to measure your use of inpatient hospital and skilled nursing facilit...
What Is a Birthing Center? A birthing center is a healthcare facility designed to provide a comfortable, homelike setting for childbirth. Staffed pr...
What Are Bundled Payments? Bundled payments are a reimbursement model where a single, all-inclusive price is paid for every service related to a spe...
What Is a Capitated Payment Model? A capitated payment model is a system where healthcare providers are paid a set, prepaid amount for each patient ...
What Is Capitation? Capitation is the fixed, per-person payment a provider receives in a [capitated payment model](/glossary/capitated-payment-model...
What Is Cardiac Rehab? Cardiac rehabilitation is a medically supervised program of exercise and education designed to help you recover after a heart...
What Is Care Credit? Care Credit is a type of credit card specifically for financing healthcare expenses that aren't covered by insurance. It allows...
What Are Caregiver Support Services? Caregiver support services are resources designed to help unpaid family members who are caring for a loved one....
What Is Catastrophic Health Insurance? Catastrophic health insurance is a type of high-deductible plan designed as a safety net for major medical ev...
What Is a Certificate of Coverage? A Certificate of Coverage is the official legal document that details the terms of your health insurance plan. It...
What Are Certificate of Need (CON) Laws? Certificate of Need (CON) laws are state regulations that require healthcare facilities to get government a...
What Is a Certification of Medical Necessity (CMN)? A Certification of Medical Necessity (CMN) is a formal document your doctor completes to prove t...
What Is a Charge Description Master (CDM)? A Charge Description Master (CDM), or "chargemaster," is a hospital's master price list for every single ...
What Is the Charity Care Application Process? This is the formal procedure for requesting financial assistance from a hospital. It involves filling ...
What Are Charity Care Programs? Charity care programs, also known as financial assistance programs, are offered by hospitals to provide free or disc...
What Is a Chart of Accounts in Healthcare? A chart of accounts is a financial tool that hospitals and healthcare organizations use to categorize and...
What Is Chronic Care Management (CCM)? Chronic Care Management is a specific Medicare service for beneficiaries with two or more chronic conditions....
What Is a Claim Denial? A claim denial is when your insurance company refuses to pay for a medical service you've received. The insurer will send yo...
What Are Clinical Pathways? Clinical pathways are structured, evidence-based care plans for patients with a specific condition. They outline the ide...
What Is COBRA Insurance? COBRA (Consolidated Omnibus Budget Reconciliation Act) is a federal law that allows you to temporarily keep your employer-s...
What Is Coinsurance? Coinsurance is your share of the costs of a covered health care service, calculated as a percentage (for example, 20%) of the a...
What Are Medical Debt Collection Practices? These are the rules and methods that collection agencies must follow when trying to collect unpaid medic...
What Are Community Benefits? Community benefits are the programs and services that nonprofit hospitals must provide to their community to justify th...
What Is a Community Health Center? A community health center is a nonprofit clinic that provides comprehensive primary care in medically underserved...
What Are Compassionate Use Programs? Compassionate use, also called "expanded access," is a pathway for patients with serious or life-threatening co...
What Are Competitive Bidding Programs? This is a Medicare program that sets prices for certain types of [Durable Medical Equipment (DME)](/glossary/...
What Are Medicare Conditions of Participation (CoPs)? The Conditions of Participation (CoPs) are the minimum health and safety regulations that all ...
What Is a Continuity of Care Document (CCD)? A Continuity of Care Document (CCD) is a standardized electronic snapshot of your essential health info...
What Is Coordination of Benefits (COB)? Coordination of Benefits (COB) is the process used to determine which insurance plan pays first when you are...
What Is Cost-Based Reimbursement? Cost-based reimbursement is a payment method where Medicare pays certain facilities, like a [Critical Access Hospi...
What Is Cost-Effectiveness Analysis? This is a method insurers use to compare the costs and health outcomes of different treatments for the same con...
What Are Cost-Sharing Reductions (CSRs)? Cost-Sharing Reductions (CSRs) are a form of financial assistance available for people who buy a "Silver" l...
What Are CPR Guidelines? CPR (Cardiopulmonary Resuscitation) guidelines are the standardized, life-saving steps for responding to a cardiac arrest. ...
What Is Creditable Prescription Drug Coverage? "Creditable" coverage is a key Medicare term. It means your current prescription drug plan (e.g., fro...
What Is a Critical Access Hospital (CAH)? A Critical Access Hospital (CAH) is a special Medicare designation for small, rural hospitals that meet sp...
What Is Cultural Competency in Healthcare? Cultural competency is the ability of healthcare providers and systems to provide care to patients with d...
What Is a Day Surgery Center? A day surgery center, also known as an [ambulatory care](/glossary/ambulatory-care) or outpatient surgery center, is a...
What Is a Deductible? A deductible is the amount you must pay out-of-pocket for covered medical services before your health insurance plan begins to...
What Is Medicare Part B? Medicare Part B is the part of Original Medicare that covers medical services and supplies that are medically necessary to ...
What Is a Patient Advocate? A patient advocate is a trained professional who helps patients communicate with their healthcare providers, navigate th...
What Is Prior Authorization? Prior authorization (also known as pre-authorization or pre-approval) is a decision by your health insurer or plan that...
