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DEFINITION: What Is a Prior Authorization in Health Care

WebPrior authorization is a process that health care providers must go through before providing certain medical treatments or services to their patients. Insurance companies or other …

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What Is a Primary Care Provider

WebPrimary Care Provider Definition. Primary care is the basic services provided to patients, such as preventive care, immunizations, health screening, physical exams, health …

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DEFINITION: What Is Private Practice

WebA private practice refers to a business or professional practice operated by an individual or a group of professionals, typically in the health care, legal, or counseling fields. It operates …

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DEFINITION: What is the Triple Aim in Healthcare

WebThe Triple Aim is an initiative developed by the Institute of Healthcare Improvement to optimize health system performance. Key Takeaways. The Triple Aim is a framework to …

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EXPLAINED: What is Coordination of Benefits

WebCoordination of Benefits (COB) is a process that determines the payment order between multiple health insurance plans to avoid overcharging or duplicate payments. COB …

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DEFINITION: What is High Value Care

WebDefinitions. The American College of Physicians defines high-value care as, “health care that balances clinical benefit with costs and harms with the goal of improving patient …

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DEFINITION: What Is an Urgent Care

WebFinal Thoughts. Urgent care is always available to help you if you can’t wait for your primary care doctor. Now that we’ve answered the question, “What is urgent care?” you know it’s …

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EXPLAINED: What is the Cadillac Tax on Health Care

WebWhat is the Cadillac Tax on Health Care? “Cadillac Tax,” the much-reviled, or much-needed policy (depending on who you ask) was one of the Affordable Care Act’s central cost …

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DEFINITION: What is Capitation in Health Insurance

WebIn the capitation reimbursement model, insurance companies pay the healthcare provider a predetermined sum of money. In return, the healthcare provider agrees to assume part …

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DEFINITION: What Is Secondary Insurance

WebSecondary health insurance is a separate policy from your first or primary insurance. It can be a second medical plan with different coverage, or it could be a dental plan, vision …

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What are Not-For-Profit vs. For-Profit Medical Facilities

WebDiffering funding streams Not-for-profit. Not-for-profit hospitals are required to provide uncompensated care to uninsured or underinsured patients and other community …

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DEFINITION: What Is RCM in Health Care

WebFinal Thoughts. In the complex world of health care, RCM is fundamental. Now that we’ve answered the question, “What is RCM in health care?” you know medical facilities risk …

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What is Police Power in Regards to Public Health & Safety

WebWhat is Police Power? Police powers are powers “exercised by states to enact legislation and promulgate regulations to protect public health, welfare, morals and to promote the …

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Best Healthcare Newsletters: Our Top 7 Picks For 2024

WebThe Hospitalogy newsletter is our top pick for healthcare newsletters. Previously known as the Healthy Muse, Hospitalogy is an excellent resource for those interested in staying …

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DEFINITION: What Is Sales

WebSales is the lifeblood of any business. It is the process of converting prospects into customers, generating revenue, and ultimately ensuring the survival and growth of a …

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Definition: What is a Cost-Share Waiver

WebKey Takeaways. Many insurance providers have initiated cost-share waivers as a way to help out members experiencing financial hardship during the Covid-19 pandemic. Cost …

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