Word of the day

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.

Office of the Inspector General (OIG)

Office focused on identifying, auditing and investing fraud, waste, abuse, and mismanagement within the parent agency