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Gatekeeper

In a managed care system, the primary care physician who is the first doctor the patient seeks for nonemergency care and determines whether referral to a specialist is medically appropriate. The gatekeeper also controls patient access to diagnostic testing services. In some managed care plans, a nurse practitioner or physician assistant is appointed to this role. Also called primary care physician and referral provider .

Gatekeeping

Process in which a managed care system’s gatekeeper provides the initial patient care, schedules diagnostic testing services, and refers patients to specialists when necessary.

GB

HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating claim is being resubmitted for payment because it is no longer covered under a global payment demonstration.

GC

HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating service has been performed by a resident under the direction of a teaching physician. The teaching physician submits the bill for the service.

GDP (Gross Domestic Product) trigger

A trigger under a contingent capital arrangement based on trading conditions as benchmarked by changes in the growth rate of the gross domestic product in a defined trading area, e.g. Europe. The insured corporation calls in capital from an insurer when the trigger event occurs, e.g. decline in growth rates of GDP, as it will signify poor economic conditions that hit sales.

GE

1. HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating a service has been performed by a resident without the presence of a teaching physician under the primary care exception. 2. Abbreviation for gastroenterology. See gastroenterology (GE) .