One of the final stages of a long and careful research process to help patients live longer, healthier lives. Clinical trials help doctors and researchers find better ways to prevent, diagnose, or treat diseases. They test new types of medical care such as how well a new cancer drug works and if it is safe. The trials may also be used to compare different treatments for the same condition to see which is better or to test new uses for treatments already employed.

General term denoting a medical or dental practitioner who has hospital staff admission privileges and primary responsibility for care of inpatients.

1. When each entry in a patient’s medical record is worded exactly alike or similar to the previous entries. 2. When medical documentation is worded exactly the same from patient to patient. Cloning is considered a misrepresentation of the medical necessity requirements for insurance coverage of medical services. If suspected or identified, the services will be denied and may result in recovery of any overpayments made.

Conclusion of the sales presentation that leads to the signing of the insurance application.

Managed care plan that requires enrollees to select a primary care physician (PCP) from the plan’s approved panel of providers. The PCP acts as a gatekeeper and may refer the patient to a specialist when required.

To take into one’s own family by legal process and raise as one’s own child, but the identifying information about the adoptive and birth families is not shared. The adoptive and birth families do not establish or maintain contact.

Status of an insurance claim when all benefits have been paid.

Insurance agreement in which rates and policy provisions cannot be changed between the policy owner and the insurer. Commercial insurance companies write closed contracts. Fraternal insurance companies are not permitted to write this type of insurance.

List of drugs covered by a benefit plan in which the drugs on it are the only ones covered. Sometimes nonformulary drugs can be covered if authorization is obtained and if there is a good medical reason. See also open formulary and restricted formulary.