Plan of managing and controlling expensive inpatient hospital costs that supports wise utilization of medical services by moving treatment to less expensive settings when suitable and checking to be sure patients do not spend more time than necessary in the hospital.

1. Any condition of the insured’s health, job, activities, or lifestyle that could increase his or her expected mortality or morbidity. 2. In workers’ compensation when an injured worker cannot perform all job activities that he or she could do before suffering an injury but may perform some job duties. If the impairment substantially limits a major life activity, then a worker may qualify as disabled under the Americans with Disabilities Act.

Health insurance policy provision that limits or denies coverage for a specific physical impairment. Also called exclusion rider or impairment waiver .

Document explaining the proper use of a standard for a specific business purpose. The X12N Health Insurance Portability and Accountability Act (HIPAA) IGs are the primary reference documents used by those implementing the associated transactions and are incorporated into the HIPAA regulations by reference.

Under HIPAA, precise instructions or requirements for putting a standard into operation.

Contract between physician and patient not manifested by direct words but implied or deduced from the circumstance, general language, or conduct of the patient. Insurance contracts are not implied contracts because every condition is included in the policy.

Proposal for measurable process or outcome improvement. The plan is usually developed cooperatively by a provider and the managed care network. The plan must address how and when its results will be measured.