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
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Managed care
projected costs
Health care; Managed care
Claims or retention costs projected for a given patient population for a specific time period.
Section 1902 (A) (1) Segmentation
Health care; Managed care
Classes of different individuals, with different health insurance benefits, for a limited number of members.
denial code
Health care; Managed care
Classification system and identification number used to deny health insurance claims.
National Drug Code (NDC)
Health care; Managed care
Classification system for drug identification, similar to the Uniform Product Code, used by a physician or medical group.
terminal illness benefit
Health care; Managed care
Clause in a life, health, or disability insurance policy suggesting an early benefit if diagnosed with a terminal illness within a given time period.
target population
Health care; Managed care
Cohort based on age, gender, clinical focus, and target geographic areas.
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