Principal inpatient diagnostic cost group model that was phased out in 2003 and replaced by the hierarchical condition categories (HCC) model. See hierarchical condition categories (HCC) model.

In workers’ compensation, any place and adjacent premises where employment is carried out.

Where a service is performed such as a hospital (inpatient or outpatient), doctor’s office, or skilled nursing facility.

Two-digit standard codes used by providers to report the location where the medical service was provided (hospital, office, home). When the physician’s office or an outpatient hospital is billing, the two-digit POS code is inserted in Block 24B of the CMS-1500 insurance claim form (e.g., 11 is doctor’s office, 12 is patient’s home).

Individual who begins a civil legal action.
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Individual who brings a law suit against a defendant.

Referring to a managed care plan.

Department responsible for supervision of a managed care plan with job duties such as accounting, billing, legal services, marketing, personnel, purchasing, servicing of accounts, and underwriting.

Under the Health Insurance Portability and Accountability Act (HIPAA), management performed by the plan sponsor of a group health plan on behalf of the group health plan and excludes functions performed by the plan sponsor in connection with any other benefit or benefit plan of the plan sponsor.

Amount of time, in years, that a managed care plan has operated.