Word of the day

Wednesday, April 23

Claim

The process through with a beneficiary (or provider on behalf of a beneficiary) requests payment for a particular service.

Tuesday, April 22

Elimination Period

Time between when a policy holder is disabled and when insurance begins to pay out - also known as the Qualifying Period.

Monday, April 21

Indigent Care

Health care provided for free to those who do not have health coverage and cannot afford to pay out of pocket.

Thursday, April 17

Staff Model HMO

A form of HMO in which the health care providers are employees of the HMO.

Wednesday, April 16

Tertiary Care

The level of care, usually on referral from primary or secondary medical care personnel, performed by specialists that consist of complex procedures and advanced technology, often delivered in a medical facility.

Tuesday, April 15

Medicaid Expansion

The Affordable Care Act allows states to extend Medicaid benefits to eligible childless adults up to 133% of the federal poverty line.

Monday, April 14

Adjudication

Administrative process for reviewing insurance claims

Friday, April 11

Platinum Plan

The highest actuarial level health plans available through the insurance exchanges, equal to a 90 percent actuarial value. Bronze, Silver, and Gold plans offer lower actuarial values.

Thursday, April 10

Prepaid Group Practice

A form of insurance in which the health care provider is paid a preset amount, in advance, for their services.

Wednesday, April 9

Bundling

Paying for treatment for a medical condition as a single lump sum payment rather than a per-treatment or per-provider payment.

Health Information Privacy

Requirements designed to ensure that patients' information is not disclosed unnecessarily or inappropriately.