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North Carolina Department of Health and Human Services AGED, BLIND, AND DISABLED MEDICAID MANUAL

MA-200

DEFINITIONS

11 REISSUED 03/01/11 – CHANGE NO. 03-11 (III.) Assignment --- For Medicare, the medical provider's agreement to accept Medicare's approved amount. Medicare pays the provider directly and the provider may charge the patient only the 20% coinsurance. Providers must accept the Medicare assignment if they bill Medicaid for the 20% coinsurance.

Assistance Unit --- The assistance unit (a.u.) consists of the individuals for whom assistance is requested, who are eligible and in the same coverage group and who have the same financially responsible person(s).

Assisted Living --- Group care for a person who cannot remain in his own home and who is placed in a facility licensed by the Department of Health and Human Services as an adult care home.

Authorization Period --- Period for which all factors of eligibility have been established and the recipient is authorized to receive Medicaid.

Authorized Representative --- Any individual who is legally authorized or designated in writing by the applicant/recipient to act on behalf of the applicant/recipient.

Automated Notice --- A notice produced and mailed by EDS to an applicant/recipient based on codes entered by the income maintenance caseworker when action is keyed.

Award Letter --- A statement to an individual from a governmental or private agency indicating benefits for which he/she is eligible.

Base Period --- A designated time for verifying income that is counted in determining the benefit.

Battered Alien --- An immigrant who has been battered or subjected to extreme cruelty by a spouse, parent, or member of the spouse or parent’s family residing in the same household.

Beneficiary of an annuity – The beneficiary is the person who receives any benefit that is paid upon death of the annuitant prior to the maturity date of the annuity.

BENDEX --- Beneficiary Data Exchange System, a computer printout listing the amount of an individual's Social Security benefits.

Benefit Diversion --- Benefit Diversion is a cash payment assistance alternative to traditional Work First Family Assistance (WFFA) for families with a temporary, non-recurring situation associated with employment or other sources of financial stability.

Black Lung --- Payments to a disabled worker, dependents, or survivors resulting from exposure to coal dust.

Boarder --- A person who lives with the a/r and pays a set amount for a room and meals.