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General

General nature or nature terms.

Contributors in General

General

Pharmacy benefit manager (PBM)

Health care; General

PBMs are third party administrators of prescription drug benefits.

Rehabilitation

Health care; General

Rehabilitative services are normally ordered by a doctor to help a patient recover from an illness or injury. These services are given by nurses and physical, occupational, and speech therapists. ...

Physician attestation

Health care; General

The requirement that the attending physician certify, in writing, the accuracy and completion of the clinical information used for DRG assignment.

Reinsurance

Health care; General

An insurance arrangement whereby the MCO or provider is reimbursed by a third party for costs exceeding a pre-set limit, usually an annual maximum. A method of limiting the risk that a provider or ...

Physician contingency reserve (PCR)

Health care; General

Portion of a claim deducted and held by a health plan before payment is made to a capitated physician. Revenue that is withheld from a provider's payment to serve as an incentive for providing less ...

Relative value scale (RVS)

Health care; General

An index assigning various weights to various medical services. Each weight represents a relative amount to be paid for each service. The RVS used in the development of the Medicare Fee Schedule for ...

Physician current procedural terminology (CPT)

Health care; General

List of services and procedures performed by providers, with each service/procedure having a unique 5-digit identifying code. CPT is the health care industry's standard for reporting of physician ...

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