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LetterAcronymDefinition
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C & SClaims and Service
CAREClaims Adjudication and Review System
CarrierCommercial insurance company, a Blue Cross and Blue Shield plan or a Medicare claims agent.
Carve-out BenefitsCoverage stipulating that Medicare-eligible members of a group receive benefits at least equal to benefits received by non-Medicare group members. Members are reimbursed up to the group's contract limitations, less what Medicare paid or would have paid if the member were Medicare-eligible and Medicare were the primary coverage.
Case ManagementAssignment of health insurance plan staff to help a member manage chronic or severe medical conditions.
Certification555-555-0199@example.com
ChemotherapyTreatment of malignant disease by chemical or biological antineoplastic agents. High-dose chemotherapy is a type of chemotherapy often used in conjunction with tissue transplants.
Chiropractic CareA therapy administered by a licensed Chiropractor that involves manipulation or adjustment of the spine.
Chronic CareInpatient or outpatient services provided to patients who suffer from a prolonged illness.
ClaimA request for payment for benefits received or services rendered. Either the member or the provider submits claims to the carrier.
CMPColumbia Medical Plan
CMSCenters for Medicare & Medicaid Services
CNMCertified Nurse Midwife
COBContractual provision which reduces the benefits under one contract to the extent that those benefits are available under a second contract.
COBRAFederal legislation that includes a requirement for groups with 20 or more employees to offer extended health insurance coverage at the member's expense to members and eligible dependents who leave the group or are otherwise no longer eligible for the group's coverage.
COCA document describing the benefits, limitations and exclusions of coverage provided by an insurance company.
CoinsuranceThe percentage or amount members are required to pay for covered services. Coinsurance is a percentage of the allowed benefit or cost. For example, if your coinsurance is 20%, and the allowed cost is $100, your coinsurance cost would be $20.
COMPComprehensive Insurance
ContinuationLocal or federal legislation that includes a requirement for groups to offer extended health insurance coverage at the member's expense to members and eligible dependents who leave the group or are otherwise no longer eligible for the group's coverage.
Continuity of CoverageProcedure by which individuals transferring from one insurance plan to another are allowed uninterrupted coverage from the date of original enrollment.
ContraceptionMethods, drugs or devices for preventing pregnancy.
ContractA legal agreement between an individual subscriber or an employer group and a health plan that describes the benefits and limitations of the coverage.
Contract/Certificate HolderGroup or person to whom a contract or certificate is issued.
ConversionChange in a customer's contractual status. For example, transfer from group to direct payment coverage upon termination of employment.
Conversion OptionThe choice to purchase individual coverage by a person who is leaving an employee group.
CopaymentThe dollar amount a member pays when services are received, regardless of the allowed amount. For example, if your copayment is $15 for a visit to your primary care doctor, your cost would always be $15 for those visits. Your insurance plan would pay the remainder of the allowed cost. Also known as copay.
Cost SharingHealth insurance policy provisions that require insured individuals to
Covered PersonPerson, including eligible dependents, entitled to benefits under the
Covered ServicesApplies to services or supplies specified in the contract for which benefits are available under the member's plan.
CPEPContractor Performance Evaluation Program
CPTCurrent Procedural Terminology
CRNACertified Registered Nurse Anesthetist
CRNPCertified Registered Nurse Practitioner
Custodial CareCare which is provided primarily to meet the personal needs of the patient. Custodial Care does not require the continuous attention of skilled medical or paramedical personnel. Such care includes help in walking, bathing or dressing. It also includes preparing food or special diets, feeding, administering medicine or any other care that does not require continuing services of medically trained personnel.
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