Physician, health care facility, or medical supplier that has a contractual agreement with an insurance plan to render care to eligible beneficiaries and bills the insurance carrier directly. Also called participating physician, in-network provider, network provider and affiliated health care provider. Also see participating physician, participating hospitals, participating dentist, and participating pharmacy.

Association of physicians and/or medical facilities or suppliers that are a single entity and enter into an agreement to provide specific services to all of a managed care plan’s members.

1. Total number of insured individuals covered under a group insurance plan versus the total number of individuals who are eligible to have coverage. This is expressed in a percent. 2. A physician participates in an insurance plan when agreeing to accept assignment for all services he or she will give to members of the plan. Also see participating provider (par) and participation program.
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There is said to be participation when a number of insurers each accept a portion of an insurance.

Medicare program in which a physician voluntarily enters into an agreement to accept assignment for all services provided to Medicare patients.

Group of two or more providers who set up and share in the investment risk and profits of the medical practice.
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A business model in which two or more individuals join together to conduct business and share profit and losses. Commercial insurance policies usually differentiate in the Who Is Insured section among corporations, partnerships, and other business models. Therefore, the type of model being insured is important.

Buy-sell insurance agreement that provides on the death of a business partner that the partnership will purchase the share of the deceased partner and the deceased partner’s estate will sell its share to the partnership. Premiums are paid by the partnership out of income and any cash value of the insurance.

Assistance programs used to fill gaps in Medicare Part D that are offered by pharmaceutical companies to help patients who are struggling to pay for their medications. Also referred to as patient assistance programs (PAPs).

Business insurance that provides funds so that the partners in a business may purchase the business interest of a disabled partner or one who has died. Also see business-continuation insurance.