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Health Care Terms by Name
Below you will find Health Care Terms by Name. For your convenience the list is provided in alphabetical order.
- 24-Hour Coverage
- Access
- Accountable Health Plans (AHP)
- Accreditation
- Accredited
- Accrete
- Acetaminophen
- Activities Of Daily Living (ADLs)
- Actuarial Analysis
- Actuarial Cost Of Coverage
- Actuarial Soundness
- Actuary
- Acute Care
- Acute Care Bed Need Methodology
- Additional Drug Benefit List
- Adjusted Average Per Capita Cost (AAPCC)
- Adjusted Community Rating
- Adjusted Payment Rate (APR)
- Administration On Aging (AoA)
- Administrative Costs
- Administrative Costs Savings
- Administrative Loading
- Administrative Reform
- Administrative Services Only
- Administrative Services Organization (ASO)
- Admissions/1000 (APT)
- Adult Day Care
- Adult Foster Care (AFC)
- Adult Protective Services (APS)
- Advance Directive
- Advanced Macular Degeneration (Amd)
- Advanced Medical Directive
- Advanced Nurse Care Practitioner (ANCP)
- Advanced Practice Nurse (APN)
- Adverse Selection
- Aftercare
- Age/Sex Factor
- Agency For Health Care Policy And Research (AHCPR)
- Aging In Place
- Aging Network
- Aid To Families With Dependant Children (AFDC)
- Alien Insurance Company
- All Patient Diagnosis Related Groups (APDRG)
- All-Payer System
- Allied Health
- Allied Health Professional
- Allopathic
- Allowable Charge
- Allowable Costs
- Alternative Delivery And Financing Systems (ADFS)
- Alternative Delivery Sites
- Alternative Delivery System (ADS)
- Alternative Levels Of Care
- Alzheimer’s Care
- Am.
- Ambulance Restocking
- Ambulatory
- Ambulatory Care
- Ambulatory Patient Group (APGS)
- Ambulatory Setting
- Ambulatory Surgical Center (ASC)
- Ambulatory Utilization Management
- Amendments
- American Accreditation Healthcare Commission (AAHC/URAC)
- American Association Of Homes And Services For The Aging (AAHSA)
- American College Of Healthcare Executives (ACHE)
- American Health Care Association (AHCA)
- American Hospital Association (AHA)
- American Medical Association (AMA)
- American With Disabilities Act (ADA)
- Amount, Duration And Scope
- Ancillary Care
- Ancillary Charge
- Anti-Kickback Statute
- Antitrust
- Any Willing Provider
- Applicant
- Approved Charge
- Approved Health Care Facility Or Program
- Area Agency On Aging (AAA)
- Arrhythmia
- Asset
- Assignment Of Benefits
- Assisted Living Facility (ALF)
- Assistive Devices Or Technology
- Associate Degree In Nursing (AND)
- At-Risk
- Attendant
- Attrition Rate
- Audiologist
- Audit Of Provider Treatment
- Authorization
- Auto-Assignment
- Average Adjusted Per Capita Cost (AAPCC)
- Average Cost (or Average Benefit)
- Average Length Of Stay (ALOS)
- Bachelor Of Science In Nursing (BSN)
- Balance Bill
- Balance Billing
- Balanced Budget Act Of 1997 (BBA)
- Base
- Base Capitation
- Basic Benefits Package
- Bed Days/1000
- Bed Reservation Benefit
- Bedsore
- Behavioral Health Care
- Benchmarks
- Beneficiary
- Benefit
- Benefit Amount
- Benefit Cap
- Benefit Design
- Benefit Level
- Benefit Levels
- Benefit Limit
- Benefit Maximum
- Benefit Package
- Benefit Payment Schedule
- Benefit Period
- Benefit Redesign
- Benefit Year
- Benefits
- Benefits Tax
- Biased Selection
- Billed Claims
- Bio-Medical Engineering Technician
- Block Grant
- Blue Cross And Blue Shield Association (BC/BS)
- Board And Care
- Board Certified
- Board Eligible
- Boren Amendment
- Boutique Hospital
- Brand Name Medicine
- Bundled Payment
- Bundled Rate
- Bundled Services
- Buy-In
- Cafeteria Plan
- California Children Services (CCS)
- California Public Employees' Retirement System (CalPERS)
- Canadian-Style System
- Capital Costs
- Capitation
- Capitation (CAP)
- Cardiac Care
- Care Coordination Benefit
- Carrier
- Carryover
- Carve Out
- Case Management
- Case Manager
- Case Mix (or Case Mix Index)
- Case Rate
- Cash & Counseling
- Cataracts
- Catastrophic Case
- Catastrophic Coverage
- Catastrophic Health Insurance
- Catchment Area
- Categorical Grant
- Categorically Needy
- Center For Health Care Strategies
- Center For Independent Living (CIL)
- Centers For Disease Control (CDC)
- Certificate Of Authority
- Certificate Of Public Review
- Certification
- Certified Nurse Practitioner
- Certified Nurses Aid
- Charity Care
- Cherry Picking
- Children's Health Insurance Program (CHIP)
- Chronic Care
- Chronic Disease
- Civil Rights Act, 1964 (Title VI)
- Civilian Health And Medical Program Of The Uniformed Services (CHAMPUS)
- Claim
- Claims Audit
- Claims Review
- Clearinghouse
- Clinical Laboratory Improvement Act/Amendments (CLIA)
- Closed Access
- Closed Panel
- CMP
- Co-Insurance
- Co-Morbidity
- Co-Payment
- Code Of Federal Regulations
- Coding
- Cognitive Impairment
- Cognitive Impairment Reinstatement Provision
- Coinsurance (Copayment)
- Commission On Accreditation Of Rehabilitation Facilities (CARF)
- Commission On Health Care Quality (CHCQ)
- Community Based Care
- Community Care Networks
- Community Health Center (CHC)
- Community Health Information Network (CHIN)
- Community Health Purchasing Alliance (CHPA)
- Community Inclusion
- Community Integration
- Community Nursing Organization (CNO)
- Community Rating
- Community Rating By Class
- Comparability
- Competitive Bidding
- Competitive Medical Plan (CMP)
- Complaint
- Complication
- Composite Rate Or Rating
- Comprehensive Major Medical Coverage
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Computerized Medical Record (CMR)
- Computerized Patient Record (CPR)
- Concurrent Review
- Congregate Housing
- Congregate Meals
- Consolidated Omnibus Budget Reconciliation Act (COBRA)
- Consumer Directed Care
- Consumer Directed Services
- Consumer Price Index (CPI)
- Continuing Care Accreditation Commission (CCAC)
- Continuing Care Retirement Community (CCRC)
- Continuing Medical Education (CME)
- Continuous Quality Improvement (CQI)
- Continuum Of Care
- Contractual Allowance
- Contributory Program
- Convalescent Care
- Conversion
- Conversion Factors
- Conversion Privilege
- Coordination Of Benefits
- Coordination Of Coverage
- Copayment (Healthy Families)
- Cost Containment
- Cost Contract
- Cost Effectiveness
- Cost Management
- Cost Outlier
- Cost Reimbursement
- Cost Sharing
- Cost Shifting
- Cost Shifting, Employer
- Cost Shifting, Medicare
- Cost Shifting, Provider
- Cost-Based Reimbursement
- Cost-Benefit Analysis
- Coverage
- Covered Health Care Services
- Covered Person
- Covered Service
- Credentialing
- Critical Pathway
- Current Procedural Terminology
- Custodial Care
- Cytotech
- Daily Benefit Amount
- Data Base, Health Care
- Data Book
- Day Outlier
- Death Benefit
- Decision Making Capacity And Incapacity
- Decision Tree
- Decretion
- Deductible
- Deductible, Leveraging Effect
- Defensive Medicine
- Deficit Reduction Act Of 1984 (DEFRA)
- Defined Contribution Coverage
- Dehydration
- Deinstitutionalization
- Delaware Healthcare Association
- Demand Management
- Department Of Health Services (DHS)
- Dependent
- Depth Of Benefits Or Coverage
- Developmental Disability (DD)
- Diabetic Care
- Diagnosis-related Group (Drg)
- Diagnostic Guidelines
- Diagnostic Related Group (DRG)
- Diagnostic Related Group (DRG) Creep
- Dialysis Support
- Differential
- Direct Access
- Direct Contract HMO
- Direct Contracting
- Direct Cost
- Direct Spending On Health
- Directly Financed Services
- Disability
- Discharge Planning
- Disclaimer
- Discounted Fee-For-Service
- Disease Management
- Disenrollment
- Disproportionate Share
- Disproportionate Share Hospital (DSH)
- Do Not Resuscitate (DNR)
- Doctor Of Osteopathy (DO)
- Domestic Insurance Company
- Domicillary Care
- Double Indemnity
- Drug Formulary
- Drug Maintenance List
- Drug Price Review
- Drug Use Evaluation (DUE)
- Drug Utilization Review
- Dual Eligible
- Duplicate Coverage Inquiry
- Duplication Of Benefits
- Durable Medical Equipment (DME)
- Durable Power Of Attorney
- Early And Periodic Screening, Diagnosis, And Treatment (EPSDT)
- Economic Credentialing
- EEG Technologist
- EKG Technician
- Electrocardiogram (EKG)
- Electroencephalograph (EEG)
- Electronic Data Interchange (EDI)
- Electronic Medical Record (EMR)
- Eligibility Date
- Eligibility Guarantee
- Eligibility Period
- Eligibility Requirements
- Emergency Medical Services (EMS)
- Emergency Medical Technician (EMT)
- Emergency Services
- Emergi-Center
- Employee Assistance Programs (EAP)
- Employee Retirement Income Security Act (ERISA)
- Employer Contribution
- Employer Mandate
- Employment-Based Health Insurance Plan
- Encounter
- Encounters Per Member Per Year
- End Stage Renal Disease (ESRD)
- Endorsements
- Enrollee
- Enrollment
- Enrollment Broker
- Enrollment Protection
- Enterprise Liability
- Environmental Protection Agency (EPA)
- Equal Employment Opportunity Commission (EEOC)
- Essential Community Providers
- Essential Lifestyle Planning (ELP)
- Evercare
- Evidence Of Coverage And Disclosure Statement
- Evidence Of Insurability
- Excess Charge
- Exclusions
- Exclusive Provider Organization (EPO)
- Exclusivity Clause
- Expenditure
- Expenditure Limits
- Expenditure Targets
- Experience Rating
- Experimental Or Investigational
- Explanation Of Medicare Benefits (EOMB)
- Extended Care Facility
- Extension Of Benefits
- External Quality Review Organization (EQRO)
- Factored Rating
- False Claims Act
- Family Medical Leave Act (FMLA)
- Family Planning Services
- Family Premium (Healthy Families)
- Family Rest Residential Care
- Farmers Home Administration (FHA)
- Favorable Selection
- Federal Employee Health Benefit Program (FEHBP)
- Federal Financial Participation (FFP)
- Federal HMO Act
- Federal Medical Assistance Percentage (FMAP)
- Federal Poverty Level (FPL)
- Federal Qualified Health Center (FQHC)
- Federal Register
- Federally Qualified Health Centers (FQHCs)
- Federally Qualified HMOs
- Federation Of American Health Systems
- Fee Disclosure
- Fee For Service
- Fee HR Service Equivalency
- Fee Schedule
- Fee Schedule Payment Area
- Fee-for-service
- Fellow Of American College Of Healthcare Executives (FACHE)
- Fiduciary
- Financial Accounting Standards Board (FASB)
- Financing
- First Dollar Coverage
- Fiscal Intermediary
- Fiscal Note
- Fiscal Year (FY)
- Flexible Benefit Plan
- Food And Drug Administration (FDA)
- Foreign Insurance Company
- Formula Grant
- Formulary
- Foster Care
- Foundation For Accountability (FACCT)
- Frail Elderly
- Free Look Provision
- Free Standing Emergency Medical Service Center
- Free Standing Facility
- Free Standing Outpatient Surgical Center
- Freedom Of Choice (FOC)
- Frequency
- Fringe Benefits
- Full-Time Equivalent (FTE)
- Functionally Disabled
- Functionally Impaired
- Funding Level
- Funding Method
- Gag Rule Laws
- Gag-Rule
- Gatekeeper
- Gatekeeper/Care Manager
- Gatekeeping
- General Practitioner
- Generic Drug Or Substitution
- Generic Medicine
- Geographic Factor
- Geographic Multiplier
- Geriatric Nurse Practitioner
- Geriatrician
- Geriatrics
- Gerontology
- Glaucoma
- Global Budgets
- Global Service
- Grace Period
- Graduate Medical Education (GME)
- Grandfathering
- Greatest Economic Need
- Greatest Social Need
- Grievance
- Grievance Procedure
- Group Health Insurance
- Group Insurance
- Group Model HMO
- Group Practice Association
- Group Practice HMO Model
- Group Purchasing Organization (GPO)
- Group-model Hmo
- Guaranteed Issue
- Guaranteed Renewability
- Habilitation
- HCFA Common Procedural Coding System (HCPCS)
- Health Alliances
- Health And Human Services (HHS)
- Health And Welfare Fund
- Health Benefits Manager
- Health Care Coalition
- Health Care Data Base
- Health Care Decision Counseling
- Health Care Delivery System
- Health Care Expense, Direct
- Health Care Financing Administration (HCFA)
- Health Care Options
- Health Care Prepayment
- Health Care Prepayment System (HCPP)
- Health Care Provider
- Health Care Proxy
- Health Care Reform
- Health Care Services
- Health Insurance
- Health Insurance Association Of American (HIAA)
- Health Insurance Claim Number
- Health Insurance Portability And Accountability Act (HIPAA)
- Health Insurance Trust Fund
- Health Insuring Organization
- Health Level Seven (HL7)
- Health Maintenance Organization (Hmo)
- Health Manpower Shortage Area (HMSA)
- Health Plan
- Health Plan Employer Data And Information Set (Hedis)
- Health Plan Employer Data And Information Sets (HEDIS)
- Health Professional Shortage Area (HPSA)
- Health Promotion
- Health Services
- Health Services Corporation (HSC)
- Health System
- Healthcare Financial Management Association (HFMA)
- Healthy Families Program
- Healthy Start
- Heart Murmur
- High Blood Pressure
- Hill Burton Act
- Hill-Burton Program
- Histo-Tech
- HMO
- HMO Lookalike
- HMO, Closed Panel
- Hold Harmless
- Home And Community Based Waiver
- Home And Community-Based Services (HCBS)
- Home Care
- Home Delivered Meals
- Home Health
- Home Health Agency
- Home Health Care Agency
- Home Medical Equipment
- Homemaker
- Horizontal Integration
- Hospice
- Hospice Care
- Hospital
- Hospital Affiliation
- Hospital Alliance
- Hospital Insurance Program
- Hospital Market Basket
- Hospital Market Basket Index
- Hospitalist
- Housekeeper
- Housing And Urban Development (HUD)
- Hybrid-Model HMO
- Impairment
- In-Kind Resources
- Incentive Plans
- Incentives
- Incidence
- Incurred But Not Reported Expenses (IBNR)
- Incurred Claims
- Indemnity Benefits
- Indemnity Health Plan
- Indemnity Insurance
- Indemnity Plans
- Independent Case Management
- Independent Living
- Independent Medical Evaluation (IME)
- Independent Practice Association (Ipa)
- Indigent Care
- Indigent Medical Care
- Indirect Costs
- Individual Case Management
- Individual Health Care Account
- Individual Health Insurance
- Individual Insurance
- Individual Practice Association Model (IPA)
- Individual Tax Credits
- Infant Mortality Rate
- Inflation Protection
- Inflation Rider
- Informal Care
- Informal Support
- Informed Consent
- Infusion (Iv) Therapy
- Inlier
- Inpatient
- Inpatient Care
- Inpatient Services
- Inside Limits
- Insolvency
- Institutional Care
- Instrumental Activities Of Daily Living (IADL)
- Insurance
- Insurance Market Reform
- Insurance Reform
- Insured Claims Loss Ratio
- Insurer
- Insurer HMO
- Integrated Care
- Integrated Delivery System
- Integrated Provider Network (IPN)
- Integrated Services Network (ISN)
- Intensive Care Units (ICU)
- Intermediary
- Intermediate Care
- Intermediate Care Facility (ICF)
- Intermediate Care Facility For Mentally Retarded Persons (ICF/MR)
- Intern
- International Classification Of Diseases, 9th Edition (ICD-9)
- Interpreter
- Intervention Strategy
- Intractable Pain
- Job-Lock
- Joint Commission On Accreditation Of Healthcare Organizations (JCAHO)
- Joint Venture
- Key Indicators
- L.A. Care Health Plan
- Laboratory Supervisor
- Large Case Management
- Least Restrictive Environment
- Legend Drug
- Length Of Stay (LOS)
- Level Of Care (LOC)
- Licensed Practical Nurse (LPN)
- Licensed Social Worker (LSW)
- Licensure
- Life Safety Code
- Lifetime Reserve Days
- Limiting Coverage
- Living Will
- Lock-In
- Long Term Care Ombudsman Program (LTCOP)
- Long Term Care Options Program (LTCOP)
- Long Term Care Rider
- Long-Term Care
- Long-term Care Insurance
- Loss Ratio
- Low Heart Rate (Bradycardia)
- Low-Level Radio Active Waste
- M/R Coder
- Magnetic Resonance Imaging (MRI)
- Mail Order Pharmacy
- Maintenance Drug
- Maintenance Of Benefits (MOB)
- Major Diagnostic Category (MDC)
- Malpractice
- Malpractice Insurance
- Managed Care
- Managed Care Organization (MCO)
- Managed Competition
- Managed Fee-For-Service
- Managed Health Care
- Managed Health Care Plan
- Managed Risk Medical Insurance Board (MRMIB)
- Management Guidelines
- Management Services Organization (MSO)
- Mandated Benefits
- Mandated Benefits, Federal Preemption
- Mandated Employer Insurance
- Mandated Providers
- Manual Rates
- Market Area
- Market Penetration
- Market Share
- Market-Based Reform
- Marketplace Medicine
- Match Certain Grants
- Material Safety Data Sheet (MSDS)
- Maternity-Stay Legislation
- Maximum Allowable Charge
- Maximum Allowable Costs List (MAC)
- Maximum Out Of Pocket Costs
- Medi-Cal
- Medicaid
- Medicaid (Title XIX)
- Medicaid Management Information System (MMIS)
- Medicaid Prudent Pharmaceutical Purchasing Act (MPPPA)
- Medicaid Waivers
- Medical Care Evaluation Studies (MCE)
- Medical Consumer Price Index
- Medical Doctor (MD)
- Medical Foundations (MF)
- Medical Group
- Medical Indigence
- Medical IRA
- Medical Laboratory Technician
- Medical Laboratory Technologist (ASCP)
- Medical Loss Ratio
- Medical Protocols
- Medical Savings Account (Msa)
- Medical Services Organization (MSO)
- Medical Technology
- Medical Transcriptionist
- Medical Underwriting
- Medically Indigent
- Medically Necessary
- Medically Needy
- Medically Unnecessary Days (MUD)
- Medicare
- Medicare (Title XVIII)
- Medicare + Choice
- Medicare Bonus Payment
- Medicare Cost HMO Or Contract
- Medicare Cost Report (MCR)
- Medicare Insured Group (MIG)
- Medicare Payment Advisory Commission (MedPAC)
- Medicare Provider Analysis And Review File (MedPAR)
- Medicare Risk Contract
- Medicare Secondary Payer
- Medicare Select
- Medicare Self Referral Option
- Medicare Supplement Policy
- Medicare Waiver (222)
- Medicare+choice
- Medigap
- Medigap Insurance/Medicare Supplemental Insurance
- MedSupp
- Member
- Member Month
- Member Services Department
- Members Per Year
- Mental Health Services
- Mid Level Practitioner
- Miller Trusts
- Minimum Benefits
- Minimum Data Sets (MDS)
- Minimum Premium
- Minnesota Care
- Mixed Model HMO
- Modified Community Rating
- Modified Fee-For-Service
- Moral Hazard
- Morbidity
- Mortality
- Most-favored-nation Clause
- Multiple Employer Trust
- Multiple Employer Welfare Arrangement
- Multiple Option Plan
- Multipurpose Senior Center
- Multispecialty Group
- National Board Of Medical Examiners
- National Cancer Registry
- National Center For Health Services Research
- National Center For Health Statistics
- National Claim History (NCH)
- National Committee For Quality Assurance (NCQA)
- National Drug Code (NDC)
- National Fire Protection Association (NFPA)
- National Health Board (NHB)
- National Health Expenditures
- National Health Insurance
- National Institute On Aging (NIA)
- National Institutes Of Health
- National Practitioner Data Bank
- Negotiated Fee Schedule
- Net Loss Ratio
- Network
- Network Model Hmo
- Network-Model HMO
- NFPA Storage Codes
- Noncontributory
- Nonforfeiture Feature
- Nonparticipating Provider
- Nuclear Medicine Technologist
- Nuclear Regulatory Commission (NRC)
- Nurse
- Nurse Assistant
- Nurse Manager
- Nurse Practitioner (NP)
- Nurses Aide
- Nursing Facility (NF)
- Nursing Supervisor
- O.R. Tech
- Occupancy Rate
- Occupational Safety And Health Administration (OSHA)
- Occupational Therapist (OT)
- Occupational Therapy
- Off-Open Enrollment Termination
- Office Of Civil Rights
- Office Of Inspector General (OIG) Of The U.S. Department Of Health And Human Services
- Office Of Management And Budget (OMB)
- Office Of Personnel Management (OPM)
- Office Of Professional Standard Review Organizations
- Older Americans Act (OAA)
- Omnibus Budget Reconciliation Act (OBRA)
- Open Access
- Open Ended HMO
- Open Enrollment
- Open Enrollment Termination
- Open Panel HMO
- Organ Procurement Organization (OPO)
- Organized Delivery System
- Orthotic
- ORYX
- Osteopathic
- Out Of Network
- Out Of Plan
- Out-Of-Area Benefits
- Out-Of-Pocket Expenses Or Costs
- Out-Of-Pocket Maximum Or Cap
- Outcome And Effectiveness Research
- Outcome Audit
- Outcome Management
- Outcome Measures
- Outcomes And Assessment Information Set (OASIS)
- Outcomes Research
- Outlier
- Outpatient
- Outpatient Services
- Outside Referral
- Over The Counter Drugs
- Overvalued Procedure
- Paid Claims
- Paid Claims Loss Ration
- Paid-Up Policy
- Pain Management
- Palliative Care
- Partial Capitation
- Partial Hospitalization Services
- Partial Risk Contract
- Participant Driven Supports
- Participating Dentist
- Participating Hospital
- Participating Physician
- Participating Provider
- Participating Specialist Or Specialist Physician
- Patient
- Patient Advocate
- Patient Origin Study
- Patient Protection Acts
- Patient Self-Determination Act
- Payer
- Payment Withhold
- Peer Review
- Peer Review Organization (PRO)
- Per Capita Health Care Spending
- Per Case Payment
- Per Diem Rate
- Per Member Per Month (PMPM)
- Percent Of Premium
- Performance Measures
- Performance Standards
- Person Centered Planning
- Personal Attendant Services (PAS)
- Personal Care
- Personal Care Advisor
- Personal Care Advocate
- Personal Emergency Response System (PERS Or PRS)
- Personal Futures Planning
- Pharmaceutical Care
- Pharmacist
- Pharmacy And Therapeutics (P&T) Committee
- Pharmacy Services Administrative Organization (PSAO)
- Pharmacy Tech
- Phlebotomist
- Physical Therapist
- Physical Therapy
- Physical Therapy Assistant
- Physician
- Physician Assistant (PA)
- Physician Contingency Reserve (PCR)
- Physician Dispensing
- Physician Income
- Physician Organization Arrangement (POA)
- Physician Payment Review Commission (PPRC)
- Physician Practice Management Company (PPMC)
- Physician Services
- Physician's Current Procedural Terminology (PCPT Or CPT)
- Physician-hospital Organization (Pho)
- Plan Benefits
- Plan For Achieving Self Support (PASS)
- Plan Of Care
- Plan Partners (Medi-Cal)
- Play Or Pay Mandate
- Point Of Purchase Plan
- Point-Of-Service (POS) Plan
- Point-of-service Plan (Pos)
- Policyholder
- Political Action Committee (PAC)
- Portability
- Practice Expense
- Practice Guidelines
- Practice Parameters
- Pre-Admission Certification
- Pre-Admission Notification
- Pre-Admission Review
- Pre-Admission Screening (PAS)
- Pre-Admission Screening And Annual Resident Review (PASARR)
- Pre-Admission Testing
- Pre-Authorization
- Pre-Estimate Of Cost
- Pre-Existing Condition Exclusion
- Pre-Existing Conditions
- Pre-Service Review
- Predetermination
- Preferred Provider Organization (Ppo)
- Preferred Providers
- Premium
- Premium Cost Sharing
- Premium Support
- Premium Tax
- Premium, Community-Rated
- Premium, Experience-Rated
- Prenatal Care
- Prepaid Health Plan (PHP)
- Presbycusis
- Pressure Ulcer
- Presumptive Eligibility
- Prevalence
- Preventive Care
- Primary Care
- Primary Care Case Management (PCCM)
- Primary Care Network
- Primary Care Physician
- Primary Care Physician (PCP)
- Primary Coverage
- Prior Approval
- Prior Authorization
- Private Duty Nursing
- Probationary Period
- Process Audit
- Professional Liability Insurance
- Professional Review Organization (PRO)
- Profile Analysis
- Profiling
- Program Of All-Inclusive Care For The Elderly (PACE)
- Proportion Rules
- Proprietary Hospital
- Prospective Payment Assessment Commission (ProPAC)
- Prospective Payment Review Commission
- Prospective Payment System (Pps)
- Prospective Pricing
- Prospective Review
- Prosthesis
- Provider
- Provider Directory
- Provider Reimbursement Review Board
- Provider-Services Network
- Provider-sponsored Organization (Pso)
- Providers
- Pryor Bill
- Public Health Service
- Pure Premium
- Qualified Medicare Beneficiary (QMB)
- Quality Assessment
- Quality Assurance
- Quality Assurance Reform Initiative (QARI)
- Quality Compass
- Quality Improvement
- Quality Improvement Organization (QIO)
- Quality Improvement System For Managed Care (QISMC)
- Quality Of Care
- Quality-Adjusted Life-Year
- Quality-Of-Life Measures
- Race To The Bottom
- Rate Cell
- Rate-Setting
- Rating
- Rating Bands
- Reasonable And Customary Fee
- Recidivism
- Recipient
- Reciprocity
- Reconsideration
- Redlining
- Referral
- Refined Diagnosis Related Group (RDRG)
- Regional Community Advisory Committees (RCAC)
- Registered Nurse (RN)
- Registered Respiratory Therapist
- Regulation
- Rehabilitation
- Reinstated Benefits
- Reinsurance
- Relative Value Scale (RVS)
- Renewability
- Renewable At The Option Of The Insurance Company
- Renewal
- Report Card On Health Care
- Report Cards
- Required Request
- Reserves
- Resident
- Resident Assessment Instrument (RAI)
- Resident Assessment Protocols (RAPs)
- Resident Centered Care
- Resource Conservation And Recovery Act (RCRA)
- Resource Utilization Groups (RUGS III)
- Resource-Based Relative Value Scale (RBRVS)
- Respiratory Services
- Respiratory Therapy
- Respiratory Therapy Technician (Uncertified)
- Respiratory Therapy Technician Certified (CRTT)
- Respite Care
- Rest Residential Care
- Restoration Of Benefits
- Retention
- Retroactive Review
- Retrospective Review
- Return Of Premium Benefit
- Review, Concurrent
- Review, Peer
- Review, Private
- Review, Utilization
- Rider
- Risk
- Risk Adjuster
- Risk Adjustment
- Risk Agreement
- Risk Analysis
- Risk Assessment
- Risk Contract
- Risk Control Insurance
- Risk Corridor
- Risk Factors
- Risk Load
- Risk Pool
- Risk Pools, Medically Uninsurable
- Risk Pools, Residual Risk
- Risk Product
- Risk Segmentation
- Risk Selection
- Risk Sharing
- Risk Withhold
- Risk-Bearing Entity
- Robert Wood Johnson Foundation (RWJ)
- Room And Board
- Routine Notification
- Scope Of Benefits Or Coverage
- Scored Savings
- Screening
- Second Opinion
- Second Opinion Program
- Secondary Care
- Secondary Coverage
- Section 89, Internal Revenue Code
- Selective Contracting
- Self Referral
- Self-Administered Plan
- Self-Funding
- Self-insurance
- Self-Insured
- Sentinel Event
- Service Area
- Service Guideline
- Service Substitution
- Severity Modifier
- Shared Risk
- Shared Savings
- Single Contract
- Single Payer
- Single Payer System
- Site-of-Service Differential
- Skilled Care
- Skilled Nursing Facility
- Skilled Nursing Facility (SNF)
- Small Employer Health Insurance Availability Act
- Small Group Market
- Small Group Pooling
- Small Market Insurance Reform
- Social HMO (S/HMO)
- Social Security Act
- Social Security Administration
- Social Service Block Grant (SSBG)
- Social Worker
- Socialized Medicine
- Sole Community Hospital (SCH)
- Special Imaging Technician
- Special Risk Insurance
- Specialist
- Specialty Differential
- Specialty HMO
- Specified Disease Insurance
- Specified Low Income Medicare Beneficiaries (SLMB)
- Speech Therapist (ST)
- Speech Therapy
- Speech Therapy Treatment
- Spend Down
- Sponsor
- Spousal Discount
- Staff Model HMO
- Staff Nurse
- Staff-model Hmo
- Standard Benefits Package
- Standard Class Rate (SCR)
- Standing Referral
- Stark II
- State Defined Plan
- State Mandated Benefits Laws
- State Unit On Aging (SUA)
- State/Private Insurer Long-Term Care Partnerships
- Statute
- Stop Loss
- Stop Loss Insurance
- Stop-loss
- Stroke (Cva)
- Sub-Capitation
- Subacute Care
- Subrogation
- Subscriber
- Subscriber Contract
- Summary Plan Description
- Superbill
- Supplemental Medical Benefits
- Supplemental Medical Insurance
- Supplemental Security Income (SSI)
- Supplemental Services
- Supports
- Surgicenter
- Survey And Utilization Reviews (SURS)
- Swing Beds
- Table Rates
- Targeting
- Tax Cap
- Tax Credit
- Tax Deduction
- Tax Equity And Fiscal Responsibility Act Of 1982 (TEFRA)
- Tax Incentives
- Teaching Hospital
- Technology Assessment
- Telemedicine
- Temporary Assistance To Need Families (TANF)
- Tertiary Care
- Therapeutic Alternatives, Equivalents, Or Substitution
- Therapeutic Devices
- Third Party Payment
- Third-Party Administrator (TPA)
- Third-Party Payor
- Three Tier Rate
- Tinnitus
- Title XIX
- Title XVII
- Title XX
- Title XXI
- Tort
- Tort Reform
- Total Compensation Package
- Transfer
- Trauma Center
- Treatment Facility
- Trend Factor
- Trending
- Triage
- Triple Option Plan
- Tumor Registrar
- Two Tier Rate
- Tylenol
- U.S. Department Of Health And Human Services (HHS)
- U.S. Department Of Housing And Urban Development (HUD)
- Ultra-Sound Technician
- Unbundling
- Uncompensated Care
- Undergraduate Medical Education
- Underinsured
- Underwriting
- Uniform Benefits
- Uniform Billing Code Of 1992 (UB-92)
- Uniform Claim Form
- Uniform Health Data Act
- Uniform Hospital Discharge Data Set
- Uninsured
- Uninsured Population
- Unintentional Weight Loss
- Unit Clerk
- Universal Access
- Universal Coverage
- Urgent Services
- Usual, Customary And Reasonable Charges (UCR)
- Utilization
- Utilization Management
- Utilization Review (Ur)
- Utilization Review Accreditation Commission (URAC)
- Utilization Review, Delegated
- Utilization Review, Non-Delegated
- Vendor
- Ventilator
- Ventilator Dependent
- Vertical Integration
- Veterans Administration (VA)
- Vocational Rehabilitation (VR)
- Volume Performance Standard
- Voucher
- Waiting Periods
- Waiver
- Waiver Of Premium Provision
- Ward Clerk
- Well-Baby Care
- Wellness
- Withhold
- Withhold Fund
- Work-Up
- Workers' Compensation
- Wound Management
- X-Ray Technician
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