Two basic ways of controlling health care costs are
competition and regulation
related medical groups contributing their diagnosis of the nature of a patient's disease on which standardized fees are based.
diagnostic related groups (DRGs)
likely to come about; looking forward to the future
prospective payment system
ownership of a business by one person
an association of two or more individuals to act as co-owners of a business venture
a means by which a group of people can unite to create an entity to do something impossible for the individual members. The organization is established by filling a certification of corporation in the state where its main place of business is located
a corporation diversifying operations by acquuiring varied enterprises
business structure with corporation and partne5rship qualities, which provides protection from personal liabilities like a corporation and the tax advantages of a partnership.
limited liability corporation
a form of general partnership that provides protection from liability for an individual partner for certain partnership obligations
limited liability partnership
the assents in money or property accumulated by individual, partnership, or corporate owndrship of a business; net worth
personal belongings and property owned by a person or, if he or she has died, by his or her estate
an announcement, written or displayed, gibing peertinent information to whose interested in a certain person, place, or event, or in any legal agreement such as a partnership
money, services, or goods owned to some person or persons to some person or persons to whom one is obligated.
those to whom money or its equivalent is owed
units of stock giving the possessor part ownership in a corporation
persons holding formal positions of trust in an organization, especially those involved in high levels of management
a term used to describe a system of integration of the financing and delivery of health
those elected and terminated by stockholders to management responsibility in a corporation
those who hold an interest (stock) in a corporation
In the context of managed care, what does gatekeeper mean to you?
Primary physician control who you see
are the benefits of managed care?
keeps costs down
what are the disadvantages of managed care
may not receive care you need
what is prior authorization for managed care?
ask insurance if procedure can be done
expenditure of capital to secure income or profit
direction or administration of the affiars of a person, business, or organization
regulations adopted by a corporation or association to govern its internal
the gains accrued from a business or investment after the payment of expenses
profits of a corporation
pay equally according to the number of individuals
per capita payment
one who agrees to buy or belong for a peroid of time
payment in a lump sum to physicians, HMO's, and health care facilities to deliver health care to a segment of the population
basis of professional billing, either so much per hour or per identified procedure
covering completely or broadly: inclusive
a group of persons together performing some business undertaking
the process of the submission and consideration of offers until an offer is accepted. Fee schedule refers to the amount an insurance company or other third-party payer will reimburse for a medical procedure.
negotiated fee schedules
a process by which hostipals review patient progress to efficiently allocate scarce medical resources
failure to treat all persons equally when there is no reasonable distinction between those favored and those unfavored
the movement of goods and services , or services that rely on the movement of goods, which cross state borders within the United States
between two or more states
the force of impression of one thing on another
a marked difference between two things
process of reasoning by which a fact is deduced as a logical consequence of other facts
on the surface the matter is impartial, or does not take an active part in either side
having more evidence for than against
probable cause (reasonable cause)
a way of practicing medicine when the patient is in one location and the treating physician is in another, possibly thousands of miles away.
benefits paid to an employee for a prior term of service after he or she discontinues work for that employer
the representation of one thing or person similar to another
procedural attempt to achieve collective agreements between an employer and accredited representative of employees, to improve the condition of employment
the labor union, or group of employees with similar interests, authorization to conduct negotioations on bhalf of the employees who are members of the union or group
honesty of intention
minimizing the danger or hazard
responsibility to uphold the quality of care of patients in treatment situations
conduct that is against common knowledge that, by its act, without argument, can be deligated negligence
negligent per se
make less severe due to considerations of fairness and mercy
to raise or execute a tax
an offer of money from one person to another
the particular county or geographic area where a court may try a case
Family and Medical Leave Act
a federal insurance program for people who are entitled to _____ from their social security contributions and payment of premiums.
is a program jointly administered by the federal government and state government for low-income individuals obtainable through social services or welfare departments