Glossary

A process used to decide what a patient needs for a smooth move from one level of care to another. This is done by a social worker or other health care professional. It includes moves from a hospital to a nursing home or to home care. Discharge planning may also include the services of home health agencies to help with the patient's home care.

Release or divulgence of information by an entity to persons or organizations outside of that entity.

Under HIPAA this is a list of any entities that have received personally identifiable health care information for uses unrelated to treatment and payment.

A list of certain drugs and their proper dosages. The discount drug list includes the drugs the company will discount.

Outlays of funds subject to the Federal appropriations process.

Ending your health care coverage with a health plan.

A hospital with a disproportionately large share of low-income patients. Under Medicaid, States augment payment to these hospitals. Medicare inpatient hospital payments are also adjusted for this added burden.

Reduce the value and code of a claim when the documentation does not support the level of service billed by a provider.

An archaic term for any X12 standard that has been approved since the most recent release of X12 American National Standards. The current equivalent term is "X12 standard".

The DRG categories used by hospitals on discharge billing. See also "Diagnosis-related groups (DRGs)."