for DR.SAMUELSON only!!!!

MHCM 6310 Strategic Management of Health Services Organizations

Key Terms

 Commercial market  Medicare  Medicaid

 Life Events  Election period

 CPT (Current Procedural Terminology)  ICD-10-CM (International Classification of Diseases: Clinical Modification)

 Explanation of Benefits (EOB)  Inventory control  Adjudication

 Claims capability  Fraud

 Abuse  Data analytics  Predictive modeling

 Primary Care Physician (PCP

 Evidence of Coverage (EOC)