Independent evaluation of hospital bills by an external auditor (third party) to investigate if medical services and supplies billed to the patient were those actually given and if the fees were for the correct amounts.

Inpatient and outpatient care, procedures, supplies, and medical services provided and billed by a hospital facility.

Cost sharing in which a Medicare Part A beneficiary must pay a daily amount for the 61st through 90th day of hospitalization. It is equal to one fourth of the inpatient hospital deductible. For lifetime reserve days, a Medicare beneficiary must pay a daily amount that is equal to one half of the inpatient hospital deductible. See lifetime reserve .

Continuous stay in an acute hospital, skilled nursing facility, or other inpatient facility for a specific time period. This phrase is commonly seen in insurance contracts where benefits are listed.

Type of health insurance that gives a predetermined benefit amount for each day an insured is in the hospital. Some policies provide higher benefit amounts if the insured is in an intensive or cardiac care unit. Also called hospital indemnity insurance .

Formal legal agreement between a managed care plan or insurance company with a hospital facility to provide inpatient and outpatient medical services to members of the plan with payment for the care by the plan.

Twenty-four-hour period when a patient is admitted to the hospital as an inpatient. The day of admission is considered a hospital day, but the day of discharge from the hospital is not. The time a patient spends receiving medical services as an outpatient is not considered as a hospital day.

Utilization measurement of the number of days per year of inpatient hospital care by members in a managed care plan. The formula is calculated by taking the total number of days spent in the hospital by the members and dividing it by the total number of members.

Type of insurance that has certain benefits for hospital services and associated medical expenses for treatment of a illness or injury. Most policies cover hospital charges for room and board and hospital services, surgeon’s and physician’s fees during a hospital stay, specific outpatient expenses, and extended care services such as convalescent or nursing home costs. Also called hospital-surgical expense insurance .
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Health insurance protection against the costs of hospital care resulting from the illness or injury of an insured person.

Group insurance benefit that covers hospital supplies and services other than room and board daily charges (e.g., x-rays, laboratory tests, medications, surgical dressings, anesthetics, use of an operating room). Also called miscellaneous hospital expense benefit .