TermsStudyGuideFA08 - Terms Acronyms Study Guide Terms...

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Terms & Acronyms Study Guide Terms Access – refers to the ability of an individual to receive healthcare services when needed. Accreditation - a process by which an agency or organization evaluates and recognizes a program of study or an activity of an institution as meeting certain predetermined standards. It is usually granted by private or professional organizations and is created to assure the public of the quality of the organization or agency. Acute care – short-term, intensive medical care for an illness or injury usually requiring hospitalization. Admits – the number of admissions to a hospital or inpatient facility. Adverse Selection - occurs when those joining a health plan have higher medical costs than the general population; if too many enrollees have higher than average medical costs, the health plan experiences adverse selection. Allied health personnel – specially trained and licensed or certified (when necessary) health workers who do not engage independent practice. [Physicians, dentists, optometrists, chiropractors, and podiatrists are independent practitioners.] Paramedical personnel may be used as a synonym. Allowable charge – charge determined by a plan (e.g. Medicare, Blue Cross, and HMO) as the maximum that the plan will pay for a service, regardless of the charge the provider sets for that service. If the actual charge exceeds the allowable charge, then the recipient of services generally pays the balance. Alternative Medicine – medical or health care services outside the traditional medical model. Examples include acupuncture, homeopathy, massage therapy, and herbal remedies. Ambulatory Care- outpatient medical services; medical care rendered to patients in physicians’ offices, outpatient departments, and health centers. Ancillary services – hospital or other inpatient services other than room and board and professional medical services such as physician and nursing care. Examples include radiology, pharmacy, laboratory, bandages and other medical supplies, and physical therapy. Average length of stay (ALOS) – the mean (average) number of days admitted patients stay in an inpatient facility. The formula for this measure is the total days of care incurred by all discharged patients divided by the total number of discharges during the period.
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Balance bill – refers to the leftover sum that a provider bills to the patient after insurance has only partially paid the charge that was initially billed. Benefits - list of health and related services guaranteed to be provided in a health plan. Benefits Manager - person in a workplace who develops and oversees a package of health, retirement, and other programs for employees. Board Certified - a physician who has passed an examination by a medical specialty
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TermsStudyGuideFA08 - Terms Acronyms Study Guide Terms...

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