A managed competition component that serves as both a provider and an insurer (payer) of health care services. AHPs compete with one another to provide the most cost-effective benefits package while also providing the highest quality of care. AHPs have preventive programmes and place an emphasis on wellness. These health plans are owned, operated, or contracted with by providers.
Also called Accountable health partnership (AHP), integrated delivery system (IDS), integrated health system (IHS), integrated health delivery system (IHDS), community accountable healthcare network (CAHN), integrated service networks (ISN), health purchasing alliance (HPA), community care network (CCN), and organised delivery systems.
Miscellaneous Medi-Cal accounting transactions as a result of cost settlements, state audits or refund checks received by the fiscal intermediary.
1. The total amount of money owed by patients to a business for professional services rendered by a provider or medical group.
2. The Money owed to a hospital facility from patients, insurance companies, managed care plans, and government programs.
Also See “day sheet”.
United Kingdom:
Procedure for enrolling an applicant as a Lloyd’s broker. Reaccreditation transpires following a three-year period. Before submitting an application to Lloyd’s, a UK applicant must receive authorisation from the FSA. The updated accreditation program permits foreign brokers to attain Lloyd’s broker status without the necessity of a UK-registered firm. International candidates must prove compliance with FSA-equivalent standards on the segregation of insurance funds, solvency, and professional indemnity insurance. There exist stipulations for reporting, oversight, grievance resolution, training and proficiency, as well as standards of conduct, all of which may consider regional stipulations.
United States, Healthcare:
1. Endorsement; an assessment procedure by which a curriculum or educational establishment is acknowledged by an outside organization for fulfilling specific established criteria. Accreditation can be either enduring or granted for a designated duration.
2. In reference to hospitals, it signifies that an institution adheres to specific quality benchmarks. These benchmarks are established by private, nationally acknowledged organisations that evaluate the quality of care (personnel and apparatus) in healthcare institutions typically every three years. Accreditation may be conferred by two entities: The Joint Commission (formerly referred to as the Joint Commission on Accreditation of Health Care Organisations [JCAHO]) and the American Osteopathic Association (AOA). Government entities at both the state and federal levels may acknowledge accreditation as a substitute for, or foundation of, licensure or other compulsory endorsements.
Also see certification.
The Accreditation Association for Ambulatory Health Care, also known as the Accreditation Association or AAAHC , was formed in 1979 to assist ambulatory health care organizations improve the quality of care provided to patients. AAAHC is the leader in ambulatory health care accreditation and accredits more than 2500 organizations in a wide variety of ambulatory health care settings including ambulatory and office-based surgery centers, managed care organizations, and Indian and student health centers. With a single focus on the ambulatory care community, the Accreditation Association offers organizations a cost-effective, flexible, and collaborative approach to accreditation. The Accreditation Association’s mission is to maintain its position as the preeminent leader in developing standards to advance and promote patient safety, quality, value, and measurement of performance for ambulatory health care through peer-based accreditation processes, education, and research.
Duration of the Centers for Medicare and Medicaid Services’ (CMS) recognition of the validity of an accrediting organization’s determination that a Medicare+Choice organization (M+CO) is “fully accredited.”
Some states use the findings of private accreditation organizations, in part or in whole, to supplement or substitute for state oversight of some quality-related standards. This is referred to as “deemed compliance” with a standard.
State requirement that managed care plans must be accredited to participate in the Medicaid managed care program.
To have a seal of approval. Being accredited means that a facility or health care organization has met certain quality standards. These standards are set by private, nationally recognized groups that check on the quality of care at health care facilities and organizations. Organizations that accredit Medicare Managed Care Plans include the National Committee for Quality Assurance, The Joint Commission, and the American Accreditation HealthCare Commission/Utilization Review Accreditation Commission (URAC).
A facility that meets certain standards of quality. These standards are set by private, nationally recognized groups that check on the quality of care (staff and equipment) at health care facilities usually every 3 years. Accreditation can be awarded by two organizations: The Joint Commission and the American Osteopathic Association (AOA). The Joint Commission has six levels—the lowest is not accredited and the highest is accredited with commendation. AOA has several levels, the lowest level being denial of accreditation and the highest being accreditation with resurvey within 3 years. State or federal governments can recognize accreditation in lieu of, or as the basis for, licensure or other mandatory approvals.
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Official approval by The Joint Commission (TJC) that the hospital facility has met the quality and high standards after their scrutiny. TJC accredits clinics, hospitals, and other federal and military facilities. See Joint Commission, The .