20 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
Add a new termContributors in Managed care
Managed care
open enrollment period
Health care; Managed care
Aft er the initial open enrollment period, the time where eligible persons may change health or benefit plans usually without evidence of insurability or waiting periods. This period of time usually ...
all-inclusive visit rate
Health care; Managed care
Aggregate costs for any one patient visit based upon annual operating costs divided by patient visits per year. This rate incorporates costs for all health services at the visit.
excess risk
Health care; Managed care
Aggregate or specific, stop-loss health, or other insurance coverage.
profile
Health care; Managed care
Aggregated data in formats that display patterns of health care services over a defined period of time.
reciprocity
Health care; Managed care
Agreement among two or more HMOs whereby a member of one HMO who is temporarily out of his or her HMO’s service area may receive treatment from another HMO for illness or injury, normally of an acute ...
discounted fee-for-service
Health care; Managed care
Agreement between a provider and payer that is less than the medical provider’s full fee. This may be a fixed amount per service or a percentage discount. Providers generally accept such contracts ...
