Flavin MLE Final Ch. 9-12 2019
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| Exclusions | A provision within an insurance policy that eliminates coverage for certain acts, types of damage, or locations.
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| Indemnification | To compensate for loss or damage; to provide financial reimbursement to an individual in case of a specified loss.
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| Premium | The amount of money an insurer charges to provide the coverage described in the policy.
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| Advance directive | The treatment preferences and designation of an alternate decision maker in the event a person should become unable to make medical decisions on their own behalf.
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| Durable power of attorney | A type of advance medical directive in which legal documents provide the power of attorney to another person in the case of an incapacitating medical condition.
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| Euthanasia | Termination of a life to eliminate pain and suffering related to a terminal illness, usually performed by giving a drug or agent to induce cessation of body functions. Also known as assisted suicide.
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| Hospice | Organization or program involving a multidisciplinary group of medical professionals available to aid in support of the terminally ill and their families.
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| Living will | A document in which the pt states their wishes regarding medical tx, especially tx that sustains or prolongs life by extraordinary means, in the event that the pt becomes mentally incompetent or unable to communicate.
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| Conflict resolution | The process of ending a disagreement between two or more people in a constructive fashion for all parties involved.
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| Mediation | The process by which a neutral 3rd party who is trained in mediation techniques facilitates and assists in resolving a dispute.
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| CHAMPVA | Acronym denoting Civilian Health and Medical Program of the Department of Veterans Affairs. Coverage designed specifically for disabled vets.
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| Co-Insurance | This is the amount of payment that is agreed upon by the insured as their portion of any claims.
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| Copay | A fixed amount determined by the health insurance policy that is paid for services to offset premiums paid by the insured.
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| Deductible | An amount of money that is paid by the insured before the ins. co. pays for services. Usually a fixed amount paid annually.
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| HMO | A type of managed care company that serves participating patients by offering services at a fixed rate within the group of participating providers and facilities. A fixed fee schedule is negotiated with the providers as well.
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| Liability | Obligations under law arising from civil actions or torts.
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| Medicaid | Federal program administered by each individual state that provides healthcare coverage for the indigent and/or medically needy patients.
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| Medicare | Federal program that provides medical insurance coverage to members older than age 65, or those who are deemed permanently disabled.
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| PCP | Primary Care Provider that is designated to oversee the care and manage the healthcare services for an individual.
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| TRICARE | Government medical program for active duty military and their dependents as well as coverage for military retirees (after 20 or more years of service).
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| Arbitration | A process using a mediator to resolve a dispute between two parties without using a judge and/or a trial process.
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| Avoiding | Conflict behavior style in which the issue is not addressed at all or is ignored.
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| Compromising | Conflict behavior style in which people give and receive in a series of trade offs.
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| Conflict | The mental struggle resulting from incompatible or opposing needs, drives, wishes, or external or internal demands.
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| Conflict resolution | The process of ending a disagreement between two or more people in a constructive fashion for all parties involved.
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| Disruptive behavior | Personal conduct, whether verbal or physical, that affects or that potentially may affect patient care negatively.
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| Mediation | The process by which a neutral 3rd party who is trained in mediation techniques facilitates in resolving a dispute.
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| Negotiation | Any communication used in an attempt to achieve a goal, approval, or action by another.
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