8 Terms
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Managed care
A health care practice intended to streamline services and provide high quality, cost-effective care.
Industry: Health care
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Managed care
first pass
Health care; Managed care
A health insurance claim that has been adjudicated from submission to payment or rejection.
group disability insurance
Health care; Managed care
A health insurance contract issued to cover designated groups having the same employer or common affiliation of interest, and that offers benefits primarily for loss of time and income, although ...
organizational determination
Health care; Managed care
A health insurance or managed care plan’s decision to pay or appeal medical services payment decisions aft er an appeal is filed.
secondary payer
Health care; Managed care
A health insurance plan that pays second-in-line for health care services. Private insurance, Medicare or Medicaid.
family expense policy
Health care; Managed care
A health insurance policy that covers the medical expenses of the policy owner and his or her immediate dependents (usually spouse and children).
comprehensive health insurance
Health care; Managed care
A health insurance policy that incorporates the coverage of major medical and basic medical expense policies into one policy.
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