Sunday, 12 February 2012

Health Maintenance Organization (HMO)

An insurance plan that pays for preventive and other medical services provided by a specific group of participating providers.
HIPAA: Health Insurance Portability and Accountability Act. This federal act sets standards for protecting the privacy of your health information.
Home Health Agency: An agency that treats patients in their homes.
Hospital Inpatient Prospective Payment System (PPS) - A federal system that pays a fixed fee for inpatient care.
Healthcare Reimbursement: Healthcare Reimbursement” is the charging of and receiving payment for provider services rendered to a patient. While a patient is responsible for paying some of the costs associated with treatment, the patient’s payor pays the bulk of the costs directly to the provider. Thus, the entity paying for a patient’s care is called a third party payor.
Covered: All other individuals who enjoy the benefit of the plan are referred to as “covered”.
Insurance Plan: Insurance coverage is referred to as an “insurance plan” and covers services that were previously agreed to. Individual is given health insurance card on purchase of the “insurance plan”, which contains details of the patient’s insurance policy.

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