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wk 3 terms/acronyms
| Term | Definition |
|---|---|
| continuity of care | documenting patient care services so that others who treat the patient have a source of information on which to base additional care and treatment |
| copayment | provision in an insurance policy that requires the policyholder or patient to pay a specified dollar amount to a health care provider for each visit or medical service recieved |
| deductible | amount for which the patient is financially responsible before an insurance policy provides coverage |
| Fee schedule | list of predetermined payments for health care services provided to patients |
| Policy holder | a person who signs a contract with a health insurance company and who, thus, owns the health insurance policy |
| socialized medicine | type of single-payer system in which the government owns and operates health care facilities and providers receive salaries |
| third party payer | a health insurance company that provides coverage, such as BlueCross BlueSheild |
| accreditation | voluntary process that a health care facility or organization undergoes to demonstrate that it has met standards beyond those required by law |
| capitation | provider accepts pre-established payments for providing health care services to enrollees over a period of time (usually on year) |
| fee for services | reimbursement methodology that increases payment if the health care service increase, if multiple units of service are provided, or if more expensive services (e.g. brand name vs generic prescription drugs) |
| gag clause | prevents providers from discussing all treatment options with patients, whether or not the plan would provide reimbursement for services |
| gatekeeper | primary care provider for essential health care services at the lowest possible cost, avoiding nonessential care, and referring patients to specialists |
| EFT | Electronic Funds Transfer |
| EHR | Electronic Healthcare Records |
| EOB | Explanation of Benefits |
| FECA | Federal Employment Compensation Act |
| HCPCS | Healthcare Common Procedural Coding System |
| HIPAA | Health Insurance Portability Accountability Act |
| HMO | Health Maintenance Organization |
| ICD | International Classification of Disease |
| IPA | Independent Practice Association |
| IPO | Integrated Provider Organization |
| IPPS | Inpatient Prospective Payment System |
Created by:
cheri le
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