29 Terms
Home > Industry/Domain > Health care > Managed care
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
actuarial assumptions
Health care; Managed care
In establishing premium rates, scheduling policy provisions, and projecting future cost increases, a MCO, HMO, or insurance company must make certain estimates. The most important assumptions are ...
conversion
Health care; Managed care
In group health insurance, the opportunity given the insured and any covered dependents to change their group insurance to some form of individual insurance, without medical evaluation upon ...
group application
Health care; Managed care
In group insurance plans, a form signed by the employer that includes schedules of insurance, eligibility requirements, method of premium payment, etc. It becomes part of the group insurance ...
self-rating
Health care; Managed care
In group insurance, a form of rating in which a large risk’s premium is determined entirely by its own losses in a given period, plus an allowance for the insured’s expenses.
debt ratios
Health care; Managed care
Comparative statistics showing the relationship between the issuer’s outstanding debt and such factors as its tax base, income, or population. Such ratios are oft en used in the process of ...
legacy systems
Health care; Managed care
Computer applications, both hardware and soft ware, that have been inherited through previous acquisition and installation. Most oft en new systems that stress open design and distributed processing ...
reconciliation code
Health care; Managed care
Computer code used to settle a health claim within a reasonable payment range.
