System of medical care in which physicians either have patients pay for whatever services are received or charge patients annual membership fees entitling them to certain services (e.g., annual physical, medical screenings for certain diseases or illnesses, preventive care). Patients are given paperwork to submit claims to their insurance companies. This system is usually for well-to-do clientele, which is why it sometimes is referred to as boutique medicine . Physicians prefer that it be called personalized, preventive care or fee-based medical care .

Informal meeting between the attorney for the workers’ compensation insurance company and the employee and/or the employee’s attorney. A conciliator is not an attorney and cannot grant the employee’s request for benefits. It is the conciliator’s job to determine if there is some way that the parties can reach an agreement and, if not, to assist in taking it to the next step to settle (resolve) the dispute.
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UK: Employment dispute resolution method originating in the Employment Act 1975 that set up the Advisory, Conciliation and Arbitration Service (ACAS). Use of ACAS is voluntary but if used, and an agreement is secured, it becomes legally binding. If the conciliation officer feels that the process has failed, recourse may be made to arbitration. Conciliation is relevant to employment practices liability insurance or legal expenses insurance.

Additional procedures completed during the same surgical session.

Provision of similar services (e.g., hospital visits) to the same patient by more than one physician on the same day. Usually there is the presence of a separate physical disorder, but it is possible they may be providing care for the same diagnosis on the same day. When concurrent care is provided, the diagnosis must reflect the medical necessity of different specialties. Also called concurrent medical care.

Process in which employees trained in coding work directly on the hospital inpatient units and code medical care as it happens.

Disorder that coexists with the primary condition, complicating the treatment and management of the primary disorder. It may alter the course of treatment required or lengthen the expected recovery time of the primary condition. It is also referred to as comorbidity or comorbidity condition.

Assessment and review that occurs at the time reimbursements are posted to financial records to evaluate the accuracy of payments received on the day of the audit.

Evaluation of health care services to determine medical necessity and appropriateness of medical care during the time the services are being provided. It is done to encourage discharge of the patient from the hospital as soon as his or her medical condition no longer needs continued inpatient care. This may occur for inpatient, residential, partial hospitalization treatment, and outpatient care. The review is usually done at the time services are provided by a health care provider other than the one giving the care.
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A case management technique which allows insurers to monitor an insured’s hospital stay and to know in advance if there are any changes in the expected period of confinement and the planned release date.