Glossary

The amount added to, or subtracted from, the hospital input price index to yield the PPS update factor.

An international organization dedicated to the elimination or simplification of procedural barriers to international commerce.

An international EDI format. Interactive X12 transactions use the EDIFACT message syntax.

Care that you get for a sudden illness or injury that needs medical care right away, but is not life threatening. Your primary care doctor generally provides urgently needed care if you are in a Medicare health plan other than the Original Medicare Plan. If you are out of your plan's service area for a short time and cannot wait until you return home, the health plan must pay for urgently needed care.

A public-private coalition for reducing health care administrative costs through the standardization and electronic exchange of health care data.

Data that are aggregated by the capitated managed care entity (e.g. the number of primary care visits provided by the plan during the calendar year).

The process by which the integrity and correctness of data are established. Validation processescan occur immediately after a data item is collected or after a complete set of data is collected.

A period of years that is considered as a unit for purposes of calculating the status of a trust fund.

A vendor of EDI data communications and translation services.

A technical strategy for creating secure connections, or tunnels, over the Internet.