Managed care

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

parol evidence rule

Health care; Managed care

A legal concept that states when an agreement has been executed in writing, any prior oral agreements must have been included in the written agreement to be considered by a court of law.

health maintenance organization (HMO)

A legal corporation that offers health insurance and medical care. HMOs typically offer a range of health care services at a fixed price (see capitation). Types of HMOs: (a) Staff Model—Organization ...

certificate of coverage (CC)

Health care; Managed care

A legal description of the benefits included under, and to be provided by, a health plan when a certificate of coverage is required by law.

certificate of need (CON)

Health care; Managed care

A legal description of the benefits included under, and to be provided by, a health plan when a certificate-of-coverage is required by law. A state agency must review and approve certain proposed ...

insolvency

Health care; Managed care

A legal determination occurring when a managed care plan no longer has the financial reserves or other arrangements to meet its contractual obligations to patients and subcontractors.

adult

Health care; Managed care

A legal determination referring to one who has reached maturity; a person who has reached the age of legal capacity and can enter into insurance contracts.