Friday, December 5
Waiting Period
A required amount of time that an individual must remain with the same employer before they are eligible for health insurance.
Thursday, December 4
Recovery Audit Contractor (RAC)
An entity, contracted with the federal government to identify and recover improper Medicare payments paid to healthcare providers.
Wednesday, December 3
Exclusion
An item, treatment, or service not covered by an individual's insurance.
Tuesday, December 2
Preferred Provider Organization (PPO)
A form of health insurance in which the enrollee pays a smaller portion of health care costs when they use pre-approved health care providers.
Monday, December 1
Provider-Sponsored Organization (PSO)
An organization of health care providers who collectively agree to act as an insurance provider.
Wednesday, November 26
Anniversary Date
The first day of a new plan year, generally the same date as the plan went into effect the previous year.
Tuesday, November 25
First Dollar Coverage
A health insurance plan that pays covered medical claims without any deductible amount paid first by the plan enrollee, can also be referred to as Zero-Deductible Health plans.
Monday, November 24
Gatekeeper
A colloquial term for a primary care physician who is responsible for coordinating patient care and referring the patient to specialists. Many insurance programs, particularly HMOs, require a referral from a "gatekeeper" before covering visits to specialists.
Friday, November 21
Medicare Part D
A program within Medicare to offer private prescription drug coverage plans to beneficiaries. Plan premiums are subsidized and the coverage is optional.
Tuesday, November 18
Sole Community Hospital (SCH)
A designation for certain hospitals that allows them to command higher reimbursement.