Health care glossary of terms

Find the definitions you need to help better understand your health care. An overall deductible applies to all or almost all covered items and services. This glossary of terms and definitions is intended to be a resource to help you better understand many commonly used terms in the medical field. Durable medical equipment dme early and periodic screening, diagnostic, and treatment services epsdt eligibility assessment. Members can see any provider in the epo network, which contains family and general practitioners as well as specialists in all areas of medicine. Certified application counselor childrens health insurance program chip.

Managed care is a health care system in which the health care provider, in return for a fixed fee per year from a health plan, manages the care of the individual, including decisions about whether a specialist is required. Health maintenance organization hmo is an organization that, through a coordinated system of health care, provides or assures the delivery of an agreed upon set of comprehensive health maintenance and treatment services for an enrolled group of persons through a predetermined, periodic fixed prepayment. Health care procedures that are still being tested, but not yet proven to treat a condition. The following is a glossary of health insurance terms that may help answer your questions. Vermont health care resources 2 health care terms a academic medical center a group of related institutions including a teaching hospital or hospitals, a medical school and its affiliated faculty practice plan, and other health professional schools. Explore anthems glossary for definitions on some of the most commonly used health insurance related terms. Terms used in talking about health care this glossary contains all of the terms provided by the united states government in their glossary of health coverage and medical terms, as well as additional terms and phrases commonly used. Uniform glossary of health coverage and medical terms. A procedure to remove excess abdominal skin and tighten the underlying stomach muscles. A benefit your employer, union or other group sponsor provides to you to pay for your health care services.

This program is funded by state and federal dollars. Our comprehensive, easytouse glossary provides definitions for common health insurance terms to help you better understand your health care. A health care plan or system that tries to control medical costs by contracting with a specific network of providers. Glossary of common health insurance terms cf foundation. Health insurance glossary health insurance definitions and terms. Medicaid provides comprehensive medical coverage for all of its recipients but because many health care providers do not accept medicaid, access to medical care is often limited. Here is a glossary of terms used in the home care industry to assist you. Health care glossary of terms pa office of attorney general. Treatments, as well as payments, are monitored and approved or denied by the insurance company. A comprehensive law passed in 2010, aimed at reforming americas health care system. A flat sheet of muscles on the front of the abdomen, between the ribcage and the pelvis. Your share of the costs of a covered health care service, calculated as a. To help you better understand health insurance, heres a list of the most commonly used health care terms and definitions. Health insurance is full of terms you may not know.

Traditional health care coverage where the patient or insurance company is billed for services provided. Coinsurance a percentage of a health care providers charge for which the patient is financially responsible under the terms of the policy copayment a flatdollar amount which a patient must pay when visiting a health care provider deductible a dollar amount that a patient must pay for. To understand the basics of health insurance, it is helpful to first know some common terms. Below is a list of words and meanings that you may come across as you use your cchp health plan. Flexible spending account fsa health insurance marketplace. Adult nursing is a bayada home health care specialty practical nurses at home for adults and seniors dealing with primarily on an ongoing shift basis home health care glossary this glossary is to help our home health care community better understand the terms used in relation to care. We want to help you to understand health insurance so you can make the most of your health plan. In this glossary, you will find some of the terms most relevant to the. This glossary of managed care terms in spanish is only one effort to improve communication, and is designed to be used as a tool to maintain consistency of terms. Exclusive provider organization epo plans offer a higher level of choice and flexibility than many other managed care plans. Insurance that pays money pays a benefit to a beneficiary if an accident causes the death of the insured person. A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically. If you need help with health insurance jargon and terminology, please see the information below for definitions of important health insurance terms, abbreviations, and acronyms. Health care terminology glossary aaahcc american accreditation health care commission aahcc accreditation is an important quality seal of approval for provider networks and managed care organizations.

Habilitation is a bayada home health care specialty practice. The definition given is the general meaning and the word may have other. Health it terms glossary of selected terms related to health it. Home health care means health care services a patient receives at home. Abortion services accountable care organization accreditation. Appeal the process of requesting a provider or health plan pay for a service for which payment has been denied autoenrollment the automatic assignment of a person to a health insurance plan broker a salesperson that has obtained a state license to sell and service health plan and insurer contracts claim a request by an individual that his or her insurance. This hormone can cause the prostate gland to grow abnormally.

Your plan may have several tiers,and your copayment amount depends on which tier your drug is listed. The controversial law is designed to lower health care and insurance costs and improve accessibility to health care. Glossary of health insurance terms blue cross and blue shield of. Health care that you get when youre admitted as an inpatient to a health care facility, like a hospital or skilled nursing facility. Eskaton glossary of health care terms this glossary of terms and definitions is intended to be a resource to help you better understand many commonly used terms in the medical field. But with this glossary, you can find commonlyused healthcare terms hat will come in handy when looking for treatment and coverage options. Health insurance glossary texas department of insurance. Health care services that your health insurance or plan doesnt pay for or cover. Sweeping health care reform legislation signed into law by president obama in march 2010. Individual coverage health reimbursement arrangement.

With health insurance coverage, there are many terms that can be difficult to understand. The most you pay in a year before your health insurance pays 100% of qualifying costs. Glossary of health coverage and medical terms page 2 of 6 deductible an amount you could owe during a coverage period usually one year for covered health care services before your plan begins to pay. Continuum of carea comprehensive and integrated system of health care that includes a broad range of care levels meant to promote the health of an individual throughout the span of their lifetime. Some excerpts were taken from wikipedia, healthcare coverage glossary. For health studies sm actuarial value a health plans actuarial value is the percentage of total aver. Health insurance glossary understanding health care. Webmd provides definitions of terms related to health insurance, the affordable care act and medicare. Behavioral health care treatment of mental health andor substance abuse disorders. It is the education, support, and assistance to enable clients with intellectual or developmental disabilities to acquire, maintain, and improve skills related to activities of daily living in order to function as meaningfully and independently as possible in the community. Some terms may have multiple and varying definitions based on the context and primary source of authority. Computerized provider order entry cpoe a computer application that allows a physicians orders for diagnostic and treatment services such as medications, laboratory, and other tests to be entered electronically instead of being recorded on order sheets or prescription pads. Medical is a california health coverage program for lowincome families. Glossary of health insurance terms excellus bluecross.

A complaint that you communicate to your health insurer or plan. Glossary of health care terms florida department of. Health care glossary childrens community health plan. These limits put a cap on health care costs if you ever have a major illness or injury. For adults over the age of 65, the picture is somewhat different. They include physician assistants, dental hygienists, medical technicians, nurse midwives, nurse practitioners, physical therapists, psychologists, and nurse anesthetists. Services that include medical and nonmedical care provided to people who are unable to perform basic activities of daily living such as dressing or bathing. A preferred provider may not balance bill you for covered services. Mvp health cares glossary of health insurance, health care, and health plan terms and definitions can help you understand your benefits and coverage, as well as help you to shop for a plan. Health care services that help a person keep, learn or. Services along the continuum include preventive health services, care management, acute care, postacute care and longterm care.

Health maintenance organization hmo a type of health benefit plan that usually limits coverage to care from doctors who work for or contract with the hmo. Ahps are individuals trained to support, complement, or supplement the professional functions of physicians, dentists, and other health professionals in the delivery of health care to patients. Think care careers has everything you need to know about working in social care. Aahcc american accreditation health care commission aahcc accreditation is an important quality. Major provisions are scheduled to gradually go into effect between now and 2014. Glossary of lgbt terms for health care teams as a provider in a health center or other health care organization, becoming familiar with terms used by lesbian, gay, bisexual, transgender lgbt communities can help you provide these patients with the highest quality care. This limit generally does not include things like your premium or noncovered services.

Military health system mhs health care glossary serves as the official repository and consolidated reference as a secondary source for terms and definitions used within the mhs. Find understandable and helpful definitions for common health insurance and healthcare terms in medical mutuals health insurance glossary. For a complete list of health insurance terms and meanings. Get definitions for common health insurance expressions and terms for a better understanding of medical insurance terminology. Coverage depends on the patients needs and health plan. This is a type of medical treatment offered in a patients home. Acute care is a branch of secondary healthcare where necessary treatment of a disease for only a short period of time in which a patient is.

A chemical that changes the sex hormone testosterone into a substance called dihydrotestosterone. Glossary of health care terms blue cross blue shield of. Your share for example, 20% of the allowed amount for covered health care services. If you need help with health insurance jargon and terminology, please see the information below for definitions of important health insurance terms.