Category: P

An arrangement where a formal association of three or more physicians provides a defined set of services to persons over a specified time period in return for a fixed periodic prepayment made in advance of the use of service.  

An injury occurring, disease contracted, or physical condition which existed prior to the issuance of a health insurance policy. Usually results in an exclusion from coverage under the policy for costs resulting from the condition. Any injury, disease, or physical condition occurring prior to an arbitrary date; usually used in reference to the date of…

Review of the need for proposed inpatient services prior to time of admission to an institution. A process by which elective care which is proposed for a patient is reviewed and approved before the patient is admitted to the hospital. When a PAC program is in effect, the care will not be paid for unless…

An urban or rural geographic area with a high proportion of low income families. Normally average income is used to define a poverty area, but other indicators, such as housing conditions, illegitimate birth rates and incidence of juvenile delinquency are sometimes added to define geographic areas with poverty conditions. The term is defined precisely, albeit…

The practice of passing a patient from one physician to another in a health program for unnecessary cursory examinations so that the program can charge the patient’s third-party for a physician visit to each physician. The practice and term originated and is most common in Medicaid mills. The transmission of an infectious disease, especially a…

An area with an inadequate supply of physicians, usually defined as an area having a physician to population ratio less than some standard, such as 1 to 4,000. A medically underserved area which is particularly short of physicians. The term is defined in the Public Health Service Act and used to determine which areas have…

The physician who assumes responsibility for the comprehensive medical care of an individual on a continuing basis. The physician obtains professional assistance when needed for services he is not qualified to provide, and coordinates the care provided by other professional personnel in light of his knowledge and understanding of the patient as a whole. While…

All those health services provided to specific individuals. Contrasted with environmental and community health, public health, consultation and education services and health education, which are all usually directed at populations, not individuals, and are undertaken to promote healthful environments, behavior or lifestyles.  

In insurance, the rate at which policies written in a given line of insurance or for members of a given group are maintained in force until the completion of the terms of the policies.  

Cause of a possible loss; such as an accident, death, sickness, fire, flood, or burglary.