Under the Health Insurance Portability and Accountability Act (HIPAA), a log that lists the individuals and companies that have received personal health information (PHI) for use that is unrelated to treatment and payment. Items to be documented must include date of disclosure, name of entity that received the PHI, brief description of the PHI disclosed, and brief statement of the purpose of the disclosure.

1. Reduction of a normal charge based on a specific amount of money or a percentage of the charge. 2. In a managed care plan’s contract with a provider, the discount is the percentage deducted during settlement of the claim from the allowed amount.
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Discount is a reduction in premium in respect of some favorable features of the risk, e.g., discount for Fire extinguishing appliances or for freedom from claims, and where customary, as in marine Insurance, originating from a reward for prompt payment of premium.

Record of certain drugs and their proper dosages that shows the drugs the pharmaceutical company will sell at a reduced cost.

Type of fee-for-service payment in which a managed care plan negotiates a discounted fee with a provider that is less than the usual or customary fee. It may be a fixed amount per service or a percentage discount. Physicians may be attracted to such negotiations because they represent a way to increase the volume of patients seen or reduce the chance of losing volume. Also called contracted discount rate .

Formal statement that a managed care plan sends to a physician or hospital facility that indicates an inconsistency between their data about the disposition of a patient such as group number or difference in claim amount.

Outlays of funds subject to the federal appropriations process.

Coordinated program that follows specific diseases or conditions and their treatments and introduces treatment to get the best outcome, prevent recurrence, and reduce the cost of care. Such programs exist for individuals who have asthma, diabetes, depression, and lipid disorders. Pharmaceutical companies work with physicians who maintain databases of drugs used to treat these diseases and conditions. Sometimes called disease state management, outcomes management, population-based care, population-based care management , or care mapping .

Overseeing a patient’s entire condition or disease state rather than treatment to individual components of a disease in isolation. Achievement of beneficial outcomes and cost effectiveness are emphasized. The patient’s overall condition is treated carefully analyzing side effects and cost of treatment.

1. Process in which a patient ends his or her health care coverage with a health plan. Generally this is now allowed unless a patient has been with a plan for at least 6 to 12 months. 2. In the Medicare program, a beneficiary may disenroll at the beginning of any given month if notice is given by a certain preceding deadline during the previous month.