| Term | Definition |
|---|
| prior authorization | pa |
| evaluation and management | e/m |
| magnetic resonance imagining | mri |
| not elsewhere classified | nec |
| emergency department | ed |
| oregon health plan | ohp |
| not otherwise specified | nos |
| chest x-ray | cxr |
| medical doctor | md |
| intramuscular | im |
| against | anti- |
| pain | -algia |
| male | andro/o |
| morph/o | shape |
| blue | cyan/o |
| water | hydro- |
| among | inter- |
| none | nulli- |
| cut | cise- |
| patellar | patell/o |
| period of time medicare is available | benefit period |
| request for reimbursement | claim |
| clinic owned by hmo | closed-panel hmo |
| eligible for both medicare and medicaid | crossover claim |
| money paid by patient | deductable |
| when a claims form is incorrect | dirty claim |
| patient to only select froma defined panel of providers | exclusive provider organization epo |
| a list of the amount to be paid by an insurance company for each procedure or service | fee schedule |
| insurance plans financed and regulated by federal and state agencies | government sponsored |
| insurance plans purchased through commercial companies | group sponsored |
| range of health care services made available to plan members | health maintenance organization hmo |
| organization o f provider sites with a contracted relationship that offer services to subscribers | integrated delivery system ids |
| fixed prepaid fee plans that are available through private insurance or government plans | managed care organizations mco |
| an organization of provider sites with a contracted relationship that offer services to subscribers | integrated delivery system ids |
| fixed prepaid fee plans that are a vailable through private insurance or government plans | managed care organizations mco |
| insurance for persons without funds | medicaid |
| a non profit integrated delivery system | medical foundation |
| social security funds for 65 and severely disabled | medicare |
| not employed by hmo | open panel hmo |
| allows patients to choose from a panel of providers | point of service plan pos |
| prior approval to receive reimbursement for services | preauthorization |
| patient must use a medical provider under contract | preferred provider organization ppo |
| monthly fee paid by the insured | premium |
| a negotiated fee for service | prepaid plan |
| physician provides all primary health care services to members of plan | primary care physician pcp |
| paperword to send patient to see another medical professional | referral |
| mothod to determine pricing factors in reimbursement | relative value studies rvs |
| enrollee chooses an out of network provider without authorization | self referral |
| member who holds insurance policy | subscriber |
| used to determine the portion that an unsurance company is obligated to pay | usual customary reasonable ucr |
| specialized health agency of the united nations | worth health organization who |
| mandated insurance for injuries related directly to work | workers compensation |
Combine with other sets
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