See: physician licensing board .
Insurance Encyclopedia
Medical Loss Ratio
Total health benefits divided by total health premium.
Medical loss ratio (Health Insurance)
A ratio calculated as total benefits divided by total premium.
Medical malpractice
Type of insurance protecting physicians, surgeons, nurses, and other medical practitioners against claims alleging failure to perform.
Medical malpractice insurance
US: Coverage for the acts, errors, and omissions of physicians and surgeons, encompassing physicians professional liability insurance, hospital professional liability (HPL) insurance, and allied healthcare (e.g., nurses) professional liability insurance. Although the majority of policies are written with a claims-made coverage trigger, such coverage is sometimes available on an occurrence basis. Typical exclusions are for are for intentional/criminal acts, punitive damages, sexual misconduct, and specialized procedures (e.g., radial keratotomy) for which coverage may be “bought back” in return for additional premium. In addition to commercial insurers, medical malpractice coverage is also available in most states through physician-owned insurance companies known as “bedpan mutuals.”
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MEDICAL,USA,REFERENCE: See: professional liability insurance (PLI) and malpractice insurance .
Medical management
System employed by health insurance and managed care plans that uses administration and policy and the individuals who make the decisions and supervise to achieve business objectives and reduce costs and use of health care services.
Medical meaningfulness
Phrase used in statistics that explains patients in the same diagnosis-related groups (DRGs) that are anticipated to have a set of clinical responses that result in a comparable pattern of use of medical services and supplies.
Medical model of health care delivery
Medical care given only when an individual is ill with emphasis on the diagnosis and treatment of disease instead of health promotion and prevention of disease.
Medical necessity
1. Performance of services and procedures required by the patient, indispensable, and consistent with the diagnosis in accordance with standards of good medical practice, performed at the proper level, and provided in the most appropriate setting. Medical necessity must be established (via diagnostic and/or other information presented on the individual claim under consideration) before the carrier may make payment. 2. Cal. Wel. & Inst. Code 14059.5 defines medical necessity when it is reasonable and necessary to protect life, to prevent significant illness or significant disability, or to alleviate severe pain. Also see medically necessary care .
medical nutrition therapy (MNT)
Specific nutritional procedures including assessment, counseling sessions, and interventions in the treatment of an acute or chronic illness, injury, or disease condition. MNT is provided by registered dietitians (RDs) and state-licensed dietitians.