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

Medicare Part B premium reduction

Health care; Managed care

A managed care organization able to use its adjusted excess premiums to reduce Medicare Part B premiums for members. Available since FY 2003.

group model

Health care; Managed care

A managed care organization that contracts with providers of an existing medical group.

medicaid MCO

Health care; Managed care

A managed care organization that provides comprehensive services to Medicaid beneficiaries, but not commercial or Medicare enrollees.

medicaid-only MCO

Health care; Managed care

A managed care organization that provides comprehensive services to Medicaid beneficiaries, but not commercial or Medicare enrollees.

certified health plan

Health care; Managed care

A managed health care plan certified by the Health Services Commission and the Office of the Insurance Commissioner to provide coverage for the Uniform Benefits Package to state residents.

proof of loss

Health care; Managed care

A mandatory health insurance policy provision stating that the insured must provide a signed and completed claim form to the insurance company within 90 days of the date of loss.

A mandatory health provision that states that the policy owner must allow 60 days aft er submitting the proof of loss forms before taking legal action, and if the policy owner sues, such action must ...