Mindblown: a blog about philosophy.

A type of cost sharing whereby insured or covered persons pay a specified flat amount per unit of service or unit of time (eg. $2 per visit, 810 per inpatient hospital day), their insurer paying the rest of the cost. The copayment is incurred at the time the service is used. The amount paid does…

Provisions and procedures used by insurers to avoid duplicate payment for losses insured under more than one Insurance policy. For example, some people have a duplication of benefits for their medical costs arising from an automobile accident, in their automobile and health insurance policies. A coordination of benefits or anti-duplication clause in one or the…

A supervisory body established in 1972 to coordinate policy matters and accreditation at all levels of medical education. Among its organizational members are the AMA, the American Board of Medical Specialties, the AAMC, the AHA, and the Council of Medical Specialty Societies. It also has public and Federal members.  

A system begun in 1970 by the American Association of Medical Colleges in which the AAMC evaluates U.S. citizens receiving undergraduate medical education outside the United States and sponsors those it deems qualified for part one of the national board examinations. Students who take and pass the boards with this sponsorship may then apply to…

A program of the National Center for Health Statistics in which Federal, State, and local governments cooperate in collecting health statistics, so that any particular item of data is collected by that level which is best equipped to collect and distribute it to all levels. When in full operation, CHSS will collect data in the…

In the Federal budget, the ability of the Congress or the President under existing law to control outlays during a given fiscal year. Uncontrollable and relatively uncontrollable describe outlays, and the programs (such as Medicare) in which they occur, that cannot be increased or decreased without changes in existing substantive law. Such spending is usually…

Group insurance in which all or part of the premium is paid by the employee, the remainder, if any, being paid by the employer or union. In this context, noncontributory insurance is insurance in which the employer pays all the premium. S0 called because the risk, or employee, contributes to the cost of the insurance…

In the Federal budget, legislation enacted by the Congress to provide budget authority for specific ongoing activities in a fiscal year in cases where the regular appropriation for such activities has not been enacted by the beginning of the fiscal year. The continuing resolution usually specifies a maximum rate at which the agency may obligate…

Review during a patient’s hospitalization to determine the medical necessity and appropriateness of continuation of the patient’s stay at a hospital level of care. It may also include assessment of the quality of care being provided. Occasionally used for similar review of patients in other health facilities. Used in the PSRO and Medicare programs where…

Reserves set aside by an insurance company for unforeseen or unplannable circumstances and expenses other than the normal losses incurred by the risks insured.