A procedure considered to be overvalued based on its relative value. The Medicare Hospital Insurance program which covers hospital and related post-hospital services. As an entitlement program, it is available without payment of a premium. Beneficiaries are responsible for an initial deductible per spell of illness and coinsurance for some services. As a voluntary program, Part B requires payment of a monthly premium.
Beneficiaries are responsible for a deductible and coinsurance payment for most covered services.
Frequently referred to as PAR . A program which provides financial and administrative incentives for physicians and suppliers to agree in advance to accept assignment on all Medicare claims for a period of one year. The total amount paid for each unit of service rendered by a healthcare provider, including both the amount covered by the insurer and the consumer's cost sharing. An organization that reviews the medical necessity and the quality of care provided to Medicare beneficiaries . A specific measure of how well a health plan does in providing health services to its enrolled population.