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
balance sheet reserve plan
Health care; Managed care
A funding plan that sets up a bookkeeping entry acknowledging some or all of the liability incurred for the payment of benefits and taking this liability into account in determining profits and the ...
performance measure
Health care; Managed care
A gauge used to assess the performance of a process or function of any organization. Quantitative or qualitative measures of the care and services delivered to enrollees (process) or the end result ...
consolidated license
Health care; Managed care
A general acute-care hospital with more than one physical plant on a single license, under specified circumstances. The second physical plant may be another hospital or a long-term care facility.
respondeat superior
Health care; Managed care
A general rule in law that a principal or employer is liable for an agent or representative’s acts performed on behalf of the principal’s business.
blue plan
Health care; Managed care
A generic designation for those companies, usually writing a service rather than a reimbursement contract, that are authorized to use the designation Blue Cross or Blue Shield and the insignia of ...
local codes
Health care; Managed care
A generic term for code values defined for a state or other political subdivision or for a specific payer. This term is most commonly used to describe the HCFA (Centers for Medicare and Medicaid ...
health plan
Health care; Managed care
A generic term to refer to a specific benefit package offered by an insurer. Also used to pertain to the insurer (e.g., “I signed up for the Golden Rule health plan today.”).
