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Health Maintenance Organization (HMO)
a type of managed care plan that offers a range of health services to plan members for a predetermined fee per member by a limited group of providers
a payment plan for medical bills that offers subscribers (members) complete medical care in return for a fixed monthly fee
a party other than the patient who assumes responsibility for paying the patient's bills (for example, an insurance company)
the person, such as a primary care physician, or entity, such as an insurance company, that approves patient referrals to other physicians or services
Primary Care Physician (PCP)
HMO-designated physician to manage and control an enrolled patient's medical care
Managed Care Organization (MCO)
a type of medical plan that pays for and manages the medical care a patient receives
a fixed monthly fee paid by an HMO to health care providers for providing medical services to patients who are members of that HMO
federal program that provides healthcare coverage for persons over 65 years of age as well as for disabled persons or those who suffer kidney disease or other debilitating ailments
federal program, implemented by the individual states, to provide financial assistance for the indigent
Diagnostic Related Groups (DRGs)
designations used to identify reimbursement per condition in a hospital; used for Medicare patients
a legal agreement in which two or more physicians share the business operation of a medical practice and become responsible for the actions of the other partners
a legal agreement in which physicians agree to share a facility and staff but do not, as a rule, share responsibility for the legal actions of each other
a type of medical practice, as established by law, that is managed by a board of directors
a business run by an individual to whom a franchisor grants the exclusive right to market a product or service in a certain market area
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