Excessive referrals to other providers for unnecessary services. A physician or facility may use this technique to gain favor with colleagues.
Tag: MEDICAL
PIP
See: periodic interim payment (PIP), personal injury protection (PIP), and physician incentive plan (PIP).
PIP-DCG model
Principal inpatient diagnostic cost group model that was phased out in 2003 and replaced by the hierarchical condition categories (HCC) model. See hierarchical condition categories (HCC) model.
PL
HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating progressive addition of lenses.
Place of employment
In workers’ compensation, any place and adjacent premises where employment is carried out.
place of service (POS)
Where a service is performed such as a hospital (inpatient or outpatient), doctor’s office, or skilled nursing facility.
place of service (POS) code
Two-digit standard codes used by providers to report the location where the medical service was provided (hospital, office, home). When the physician’s office or an outpatient hospital is billing, the two-digit POS code is inserted in Block 24B of the CMS-1500 insurance claim form (e.g., 11 is doctor’s office, 12 is patient’s home).
Plaintiff
Individual who begins a civil legal action.
***
Individual who brings a law suit against a defendant.
Plan
Referring to a managed care plan.
Plan administration
Department responsible for supervision of a managed care plan with job duties such as accounting, billing, legal services, marketing, personnel, purchasing, servicing of accounts, and underwriting.