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
patient origin study
Health care; Managed care
A study, generally undertaken by an individual health program or health plan agency, to determine the geographic distribution of the residences of the patients served by one or more health programs. ...
catastrophe
Health care; Managed care
A sudden, unexpected, unavoidable, and severe calamity or disaster. With respect to health insurance, an event that causes a medical loss of extraordinary amount.
catastrophic illness
Health care; Managed care
A sudden, unexpected, unavoidable, and severe illness, disease, disability, or injury. Catastrophic Hazard.
summary of claims processed (SOCP)
Health care; Managed care
A summary sent to the member showing how much the health insurer paid, what the member’s financial responsibility may be, and any provider write-offs.
sentinel surveillance
Health care; Managed care
A surveillance system in which a prearranged sample of reporting sources agrees to report all cases of one or more specific conditions.
all-payer system
Health care; Managed care
A system by which all payers of health care bills, such as the government, private insurers, big companies, and individuals. It pays the same rates, set by the government, for the same medical ...
zone system
Health care; Managed care
A system developed by the National Association of Insurance Commissioners for the triennial examination of insurers, under which teams of examiners are formed from the staffs of several states in ...
