Beginning and ending time when an insured is not able to perform regular job duties or cannot perform normal activities of a healthy individual of the same age or sex.

1. Phrase used in managed care plan contracts that refers to a reimbursement method that prepays providers for services based on their history of utilization by members. It is a much faster form of reimbursement than other arrangements. 2. Under the Medicare program, cost-based reimbursement method for hospitals before 1983 and the introduction of the prospective payment system (PPS).

Recalibration of Medicare’s relative value scale for financial updating purposes. The Centers for Medicare and Medicaid Services (CMS) must conduct a periodic review every 5 years.

Set period of time that the patient can get hospice care after the physician says that the patient is eligible and still needs hospice care.

Procedure that introduces dialysate into the abdominal cavity to remove waste products through the peritoneum (a membrane that surrounds the intestines and other organs in the abdominal cavity). It functions in a manner similar to that of the artificial semipermeable membrane in the hemodialysis machine. Three forms of peritoneal dialysis are continuous ambulatory peritoneal dialysis, continuous cycling peritoneal dialysis, and intermittent peritoneal dialysis. This treatment can be done at home, at work, or at another convenient location.

Phrase used when a workers’ compensation patient has been on temporary disability and his or her condition has become stabilized within a reasonable period of time and no improvement is expected. It is only after this declaration that a case can be rated for a compromise and release. Also see maximum medical improvement.