Situation that affects primary decision-making by providers or health plans that is related to competitive levels of insurance benefits or types of medical services.

Amount paid or value considered in the open market at which a security or stock can be bought or sold.
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The price actually paid or the price considered to be obtainable in the open market under the conditions currently existing.

Phrase that refers to the section, part, or portion of a specific class or type of potentially enrolled consumer for selling an insurance contract (e.g., groups under 100 employees or self-funded groups).

Section or portion of a potential market, usually expressed as a percentage, that a managed care plan has captured.

MEDICAL,USA: Current assets worth that is based on the daily stock market such as stocks, bonds, and real estate.
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The price at which insured property could have been sold just prior to its loss or damage. Along with cost new minus use deprecation, market value is but another gauge used to determine the loss settlement to which an insured is entitled. The insured may choose the gauge that produces the most favorable outcome.
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The price for which a product would sell on the current market.
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The quantity of other commodities a property would command in exchange, specifically the highest price estimated in terms of money which buyer would be warranted in paying and a seller justified in accepting provided both parties were fully informed, acted intelligently and voluntarily, and further that all the rights and benefits inherent in or attributable to the property were included in the transfer.

Provision in an insurance policy that provides that the insurance company, in the event of loss, will pay the selling price of the completed merchandise instead of cost replacement or its actual value.
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A provision that may be used in certain property insurances which obligates an insurer to pay the established market price of destroyed or damaged stock rather than its cost to the insured. This coverage is usually only available to manufacturers with finished products, not to wholesales or retailers.

1. All activities pertaining to the selling of insurance and its products to the consumer such as advertising and packaging. 2. Under the Health Insurance Portability and Accountability Act (HIPAA), make a communication about a product or service that encourages recipients of the communication to purchase or use the product or service. Marketing may also include an agreement between a covered entity and any other entity when the covered entity releases protected health information to the other entity in exchange for direct or indirect payment so that the other entity can market its product or service. Covered entities are not engaged in marketing when it exchanges information to persons about (a) participating providers and health plans in a network, the services offered by a provider, or the benefits covered by a medical plan; (b) the individual’s treatment; or (c) case management or care coordination for that individual, or directions or recommendations for alternative treatments, health care providers, or settings of care to that individual.
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The process of optimizing the use of the resources of an enterprise by seeking to identify and satisfy the needs of consumers, actual or potential in the best way for the enterprise.

In a managed care contract, a hospital facility and a managed care plan that agree to work exclusively with each other. Also see unmarried .

Location where providers administer pneumococcal pneumonia and influenza virus vaccination and submit these services as electronic media claims or paper claims or use the roster billing method. This generally takes place in a mass immunization setting such as a public health center, pharmacy, or mall but may include a physician’s office setting.