abbv&def
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| CO-PAY | COPAYMENT
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| EPO | EXCLUSIVE PROVIDER ORGANIZATION
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| FMC | FOUNDATION FOR MEDICAL CARE
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| HMO | HEALTH MAINTENACE ORGANIZATION
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| IPA | INDEPENDENT OR INDIVIDUAL PRACTICE ASSOCIATION
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| MCO | MANAGED CARE ORGANIZATION
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| PCP | PRIMARY CARE PHYSICIAN
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| POS | POINT OF SERVICE
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| PPG | PHYSICIAN PROVIDER GROUP
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| UR | UTILIZATION REVIEW
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| PHP | PREPAID HEALTH PLAN
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| BUFFING | A PHTSICIAN JUSTIFYING THE TRANSFERENCE OF SICK, HIGH-COST PATIENTS TO OTHER PHYSICIANS IN A MANAGED CARE PLAN
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| CAPITATION | A SYSTEM OF PAYMENT USED BY MANAGED CARE PLANS IN WHICH PHYSICIANS AND HOSPITALS ARE PAID A FIXED PER CAPITA AMOUNT FOR EACH PATIRNT ENROLLED OVER A STATED PERIOD OF TIME
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| CARVE OUTS | MEDICAL SERVICES NOT INCLUDED WITHIN THE CAPITATION RATES AS BENEFITS OF A MANAGED CARE CONTRACT AND MAY BE CONTRACTED SEPARATELY
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| CHURNING | WHEN PHYSICIANS SEE A HIGH VOLUME OF PATIENTS MORE THAN MEDICAL NECESSARY TO INCEASE REVENUE
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| COPAYMENT | A PATIENTS PAYMENT OF A PORTION OF THE COST AT THE TIME OF SERVICE IS RENDERED
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| DEDUCTIBLE | A SPECIFIC DOLLAR AMOUNT THAT MUST BE PAID BY THE INSURED BEFORE A MEDICAL INSURANCE PALN OR GONVERNMENT PROGRAM BEGINS CONVERTING HEALTH CARE COST
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| DIRECT REFERRAL | AUTHORIZATION REQUEST FORM IS COMPLETED AND SIGNED BY THE PHYSICIAN AND HANDED TO PATIENT TO BE DONE DIRECTLY
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| GATEKEEPER | IN THE MANAGED CARE SYSTEM THIS IS THE PHYSICIAN WHO CONTROLS PATIENTS ACCESS TO SPECIALISTS AND DIAGNOSTIC SERVICES
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| PARTICIPATING PHYSICIAN | A PHYSICIANWHO CONTRACTS WITH AN HMO OR OTHER INSURANCE COMPANY TO PROVIDE SERVICES WHO HAVE AGREED TO ACCEPT A PLAN PAYMENT
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| TERTIARY | SERVICES REQUSTED BY A SOECIALIST FROM ANOTHER SPECIALIST
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| V CODES | HEALTH CARE ENCOUNTERS THAT OCCUR FOR REASONS OTHER THAN ILLNESS OR INJURY OR SPECIAL CIRCUMSTANCES OR PROBLEMS
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| E CODES | CODING USED TO DESCRIBE ENVIRONMENT EVENTS, CIRCUMSTANCES, AND CONDITIONS AS THE EXTERNAL CAUSES INJURY, POISONING, AND OTHER ADVERSE EFFECTS
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| ACCIDENTAL | UNEXPECTED HAPPENING CAUSING INJURY TRACEABLETO A DEFINITE TIME AN PLACE
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| BENGIN | DOES NOT HAVE THE PROPERTIES OF INVASION AND METASTASIS
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| MALIGNANT | HAS THE PROPETY OF INVASION AND METASTASIS
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| METASTSIS | SPEARD OF DISEASE-PRODUCING AGENCY (AS CANCER OR BACTERIA) FROM THE INITIAL OR PRIMARY SITE IF DISEASE TO ANOTHER PART OF THE BODY
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| NEOPLASM | ANY NEW OR ABNORMAL GROWTH OF TISSUE SERVING NO PHYSIOLOGICAL FUNCTION
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| POISIONING | CONDITION RESULTING FROM AN OVERDOSE OF DRUGS OR CHEMICAL SUBSTANCES OF FROM THE WRONG DRUG OR AGENT GIVEN OR TAKEN IN ERROR
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| PRIMARY | INITIAL OR IDENTIFICATION OF THE CONDITION OR CHEIF COMPLAINT
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| THERAPEUTIC USE | CORRECT SUBSTANCE ADMINISTERED PROPERLY AND AS PRESCRIBED
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| UNCERTIAN BEHAVIOR | BEHAVIOR OF THE NEOPLASM IS UNKNOWN AND CANNOT BE ASCERTIAN UNTIL A BIOPSY OR EXCISION IS PREFORMED
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| UNSPECIFIED BEHAVIOR | DIAGNOSTIC INFORMATION HAS NOT SPECIFIED THE NATURE OF BEHAVIOR THAT MAY BE KNOWN
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Created by:
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