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
participating physician and supplier program (PAR)
Health care; Managed care
A program that provides financial and administrative incentives for physicians and suppliers to agree in advance to accept assignment on all Medicare claims for a 1-year period.
Federal Managers’ Financial Integrity Act
Health care; Managed care
A program to identify management inefficiencies and areas vulnerable to fraud and abuse and to correct such weaknesses with improved internal controls.
payment review programs
Health care; Managed care
A program used to discover medical fraud and health care abuse by provider and practitioners.
labor-delivery-recovery (LDR)
Health care; Managed care
A program, formerly approved as ABC (Alternative Birthing Center), for low-risk mothers, with equipment and supplies for uncomplicated deliveries, in a home-like setting, with stays of less than 24 ...
alternativist
Health care; Managed care
A proponent of alternativism (especially medical alternativism) or a division or subgroup thereof. A proponent of a single alternativist method (e.g., the Alexander technique or natural hygiene) is ...
cold canvassing
Health care; Managed care
A prospecting method whereby a health or life insurance agent, without any prior introduction, contacts prospects about whom he or she has little or no qualifying information.
aggregate pps operating margin/aggregate total margin
Health care; Managed care
A prospective payment system operating margin or total margin that compares revenue to expenses for a group of hospitals, rather than a single hospital. Computed by subtracting the sum of expenses ...
