1.
Accreditation: official authorization or approval for conforming to a specified standard
2.
Allopathic: Means "different suffering" and refers to the medical philosophy that dictates training physicians to intervene in the disease process, through the use of drugs and surgery
3.
Ambulatory Care Setting: facility, such as a medical office, clinic, or outpatient surgical center, that provides medical care for patients who can walk and are not bedridden
4.
Associate Practice: A medical management system in which two or more physicians share office space and employees but practice individually
5.
Certification: A voluntary credentialing process whereby applicants who meet specific requirements may receive a certificate
6.
Corporation: A body formed and authorized by law to act as a single person
7.
Cybermedicine: A form of telemedicine that involves direct contact between patients and physicians over the internet, usually for a fee
8.
E-health: Term for the use of the internet as a source of consumer information about health and medicine
9.
Endorsement: The process by which a license may be awarded based on individual credentials judged to meet licensing requirements in a new state
10.
Federal False Claims Act: A law that allows for individuals to bring civil actions on behalf of the United States government for false claims made to the federal government, under a provision of the law called qui tam (from Latin meaning "to bring an action for the king and for one's self")
11.
Gatekeeper Physician: The primary care physician who directs the medical care of managed care health plan members
12.
Group Practice: A medical management system in which three or more licensed physicians share the collective income , expenses, facilities, equipment, records, and personnel for the business
13.
Health Care Quality Improvement Act of 1986 (HCQIA): A federal statute passed to improve the quality of medical care nationwide. One provision established the National Practitioner Data Bank
14.
Health Insurance Portability and Accountability Act of 1996 (HIPPA): A federal statute that helps workers keep continuous health insurance coverage for themselves and thier dependents when they change jobs, protects confidential medical information from unauthorized disclosure or use, and helps curb the rising cost of fraud and abuse
15.
Health Maintenance Organization (HMO): A health plan that combines coverage of health care costs and delivery of health care for a prepaid premium
16.
Healthcare Integrity and Protection Data Bank (HIPDB): A national health care fraud and abuse data collection program established by HIPPA for the reporting and disclosure of certain adverse actions taken against health care providers, suppliers, or practitioners
17.
Indemnity: A traditional form of health insurance that covers the insured against a potential loss of money from medical expenses resulting from an illness or accident
18.
Individual (or Independent) Practice Association (IPA): A type of HMO that contracts with groups of physicians who practice in their own offices and receive a per-member payment (capitation) from participating HMOs to provide a full range of health services for members
19.
Licensure: A mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors
20.
Managed Care: A system in which financing, administration, and delivery of health care are combined to provide medical services to subscribers for a prepaid fee
21.
Medical Boards: Bodies established by the authority of each state's medical practice acts for the purpose of protecting the health, safety, and welfare of health care consumers through proper licensing and regulation of physicians and other health care practitioners
22.
Medical Practice Acts: State laws written for the express purpose of governing the practice of medicine
23.
National Practitioner Data Bank (NPDB): A repository of information about health care practitioners, established by the Health Care Quality Improvement Act of 1986
24.
Open Access: A managed care feature whereby subscribers may see any in-network health care provider without a referral
25.
Partnership: A form of medical practice management system whereby two or more parties practice together under a written agreement specifying the rights, obligations, and responsibilities or each partner
26.
Physician-Hospital Organization (PHO): A health care plan in which physicians join with hospitals to provide a medical care delivery system and then contract for insurance with a commercial carrier or an HMO
27.
Point-of-Service (POS) plan: A health care plan that allows members to seek health care from non-network physicians but pays the highest benefits for care when it is given by the primary care physician (PCP) or via a referall from the PCP
28.
Preferred Provider Organization (PPO): A network of independent physicians, hospitals, and other health care providers who contract with an insurance carrier to provide medical care at a discount rate to patients who are part of the insurer's plan. Also called preferred provider association
29.
Primary Care Physician (PCP): The physician responsible for directing all of a patient's medical care and determining whether the patient should be referred for specialty care
30.
Reciprocity: the process by which a professional license obtained in one state may be accepted as valid in other states by prior agreement without reexamination
31.
Registration: A credentialing procedure whereby one's name is listed on a register as having paid a fee and/or met certain criteria within a profession
32.
Respondeat Superior: Literally, "let the master answer." A doctrine under which an employer is legally liable for the acts of his or her employees, if such acts were performed within the scope of the employees' duties
33.
Sole Proprietorship: A form of medical practice management in which a physician practices alone, assuming all benefits and liabilities for the business
34.
Telemedicine: Remote consultation by patients with physicians or other health professionals via telephone, closed-circuit television, or the internet
35.
Tertiary Care Settings: Those care settings providing highly specialized services
