| HCFA 1500 Billing Form (CMS)- A form used by doctors to file insurance claims for medical services. |
| HCPC Codes- Codes used to describe what was done to you by your doctor. |
| Health Care Financing Administration (HCFA)- Former name of the government agency now called the Centers for Medicare & Medicaid Services. |
| Healthcare Provider- Someone who provides medical services, such as doctors, hospitals, or laboratories. This term should not be confused with insurance companies that "provide" insurance. |
| Health Insurance- Coverage that pays benefits for sickness or injury. It includes insurance for accidents, medical expenses, disabilities, or accidental death and dismemberment. |
| Health Maintenance Organization (HMO)- A type of health care program in which enrollees receive benefits when they obtain services that are provided or authorized by selected providers, usually with a primary care physician "gatekeeper." In general, enrollees do not receive coverage for the services of providers who are not in the HMO network, except for emergency services. |
| Healthcare Common Procedure Coding System (HCPCS)- A medical code set, which has been selected for use in the HIPAA transactions, identifies health care procedures, equipment, and supplies for claim submission purposes. HCPCS Level I contains numeric CPT codes which are maintained by the AMA. HCPCS Level II contains alphanumeric codes used to identify various items and services that are not included in the CPT medical code set. These are maintained by HCFA, the BCBSA, and the HIAA. HCPCS Level III contains alphanumeric codes that are assigned by Medicaid state agencies to identify additional items and services not included in levels I or II. These are usually called "local codes", and must have "W", "X", "Y", or "Z" in the first position. HCPCS Procedure Modifier Codes can be used with all three levels, with the WA - ZY range used for locally assigned procedure modifiers. |
| HIS - Hospital Information System- A computer-based system used to meet the clinical and support information needs of a hospital. |
| HIPAA- Health Insurance Portability and Accountability Act. This federal act sets standards for protecting the privacy of your health information. |
| HL7 - Health Level Seven- A data exchange protocol and interface for medical records and billing software that allows different systems to interoperate. |
| Home Health Agency- An agency that treats patients in their homes. |
| Hospice- Group that offers inpatient, outpatient, and home healthcare for terminally ill patients. |
| Hospital Inpatient Prospective Payment System (PPS)- A federal system that pays a fixed fee for inpatient care. |
