Program that supports the mission of the Centers for Medicare and Medicaid Services (CMS) to assure health care security for beneficiaries. HCQIP’s mission is to promote the quality, effectiveness, and efficiency of services to Medicare beneficiaries by strengthening the community of those committed to improving quality; monitoring and improving quality of care; communicating with beneficiaries and health care providers, practitioners, and plans to promote informed health choices; protecting beneficiaries from poor care; and strengthening the infrastructure.
Insurance Encyclopedia
Health care services plan
Any health insurance or managed care organization that contracts with physicians to provide hospital and medical services to enrollees on a prepaid basis.
Health coach
Individual, usually a registered nurse, who counsels patients on follow-up doctor visits, teaches a patient how to read prescription drugs, takes care of other medical needs, makes appointments with doctors, and helps discharged patients with their transition to home care. He or she makes regular house visits or talks to patients on the telephone and may be employed by an insurance company.
Health Corridor Deductible
A major medical deductible that provides for a deductible or “corridor,” after the full payment of basic hospital and medical expenses up to a stated amount. In the event of further expenses, payment is on the basis of participation or coinsurance, such as 80%-20% or 90%-10%, and the deductible is that portion paid by the insured.
Health Cosmetic Procedures
Procedures which improve the appearance, but are not medically covered.
Health Cost Containment or Control
The control or reduction of inefficiencies in the consumption, allocation, or production of health care services that contribute to higher than necessary costs.
Health Covered Expenses
Health care expenses incurred by an insured or covered person that qualify for reimbursement under the terms of a policy contract.
Health Credentialing
This involves approving a provider based on certain criteria to provide or participate in a health plan.
Health Custodial Care
Care that is primarily for meeting personal needs such as help in bathing, dressing, eating or taking medicine. It can be provided by someone without professional medical skills or training but must be according to doctor’s orders.
Health Emergency
An injury or disease which happens suddenly and require treatment within 24 hours.