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  2. National Provider Identifier - Wikipedia

    en.wikipedia.org/wiki/National_Provider_Identifier

    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 ...

  3. Centers for Medicare & Medicaid Services - Wikipedia

    en.wikipedia.org/wiki/Centers_for_Medicare...

    The Centers for Medicare & Medicaid Services ( CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.

  4. Medicare (United States) - Wikipedia

    en.wikipedia.org/wiki/Medicare_(United_States)

    Centers for Medicare and Medicaid Services logo. Medicare is a federal health insurance program in the United States for people age 65 or older and younger people with disabilities, including those with end stage renal disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease). It was begun in 1965 under the Social Security ...

  5. Physician Quality Reporting System - Wikipedia

    en.wikipedia.org/wiki/Physician_Quality...

    As of 2015, CMS included the following health care practitioners under eligible providers: Medicare providers (Physicians (Doctors of Medicine, Osteopathic Medicine), Podiatry, Optometry, Oral Surgery, Dentistry, and Chiropractic)

  6. Medicare Part D - Wikipedia

    en.wikipedia.org/wiki/Medicare_Part_D

    Medicare Part D. Centers for Medicare and Medicaid Services logo. Medicare Part D, also called the Medicare prescription drug benefit, is an optional United States federal-government program to help Medicare beneficiaries pay for self-administered prescription drugs. [1] Part D was enacted as part of the Medicare Modernization Act of 2003 and ...

  7. Medicare dual eligible - Wikipedia

    en.wikipedia.org/wiki/Medicare_dual_eligible

    Medicare dual eligible. Dual-eligible beneficiaries ( Medicare dual eligibles or "duals") refers to those qualifying for both Medicare and Medicaid benefits. In the United States, approximately 9.2 million people are eligible for "dual" status. [1] [2] Dual-eligibles make up 14% of Medicaid enrollment, yet they are responsible for approximately ...

  8. Credentialing - Wikipedia

    en.wikipedia.org/wiki/Credentialing

    Insurance credentialing / medical credentialing. Credentialing is the process the healthcare facility or managed care organization/health plan uses to collect and verify the “credentials” of the applicant. This includes verification of many elements including licensure, education, training, experience, competency, and judgment.

  9. Center for Medicare and Medicaid Innovation - Wikipedia

    en.wikipedia.org/wiki/Center_for_Medicare_and...

    The Center for Medicare and Medicaid Innovation ( CMMI; also known as the CMS Innovation Center) is an organization of the United States government under the Centers for Medicare and Medicaid Services (CMS). [1] It was created by the Patient Protection and Affordable Care Act, the 2010 U.S. health care reform legislation.

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