In workers’ compensation, a trained rehabilitation consultant who meets established criteria to administer vocational rehabilitation counseling and benefits to employees who have been injured at work.

Type of disability income insurance that gives benefits to employees when they are unable to work because of injury or illness that is not work related.

Particularly difficult situations such as extreme age, complication of total body hypothermia, controlled hypotension, or emergency condition for which a CPT add-on code (99100, 99116, 99135, or 99140) is used when an anesthesia service is provided.

Medicaid program for beneficiaries who need help in paying for Medicare Part B premiums. The beneficiary must have Medicare Part A and limited income and resources and not be otherwise eligible for Medicaid. For those who qualify, the Medicaid program pays full Medicare Part B premiums only.

Medicaid program for beneficiaries who need help in paying for Medicare Part B premiums. The beneficiary must have Medicare Part A and limited income and resources and not be otherwise eligible for Medicaid. For those who qualify, Medicaid pays a percentage of Medicare Part B premiums only.

Measuring the presence or absence of.

Referring to a test that determines the presence of an agent within the body.

1. For health plans, the general standard or grade of how well a plan keeps its members healthy or treats them when they are sick. Good-quality health care means doing the right thing at the right time, in the right way, for the right person, and getting the best possible results. 2. As defined by the Institute of Medicine, the degree to which health services for individuals and populations increase the likelihood of desired outcomes and are consistent with current professional knowledge. 3. Highest degree to which a product or service meets needs and expectations.

1. Process or activity of evaluating how well a medical service is provided. Now called quality improvement (QI) . This process may include formally reviewing health care given to a person or a group of persons, locating the problem, correcting the problem, and checking to see if the action taken worked or not. 2. Formal set of quality improvement organization (QIO) activities (formerly peer review organization [PRO]) designed to ensure the quality of medical services provided. See quality improvement (QI) .

Plan that continually assesses the effectiveness of inpatient and outpatient health care in managed care plans and federal programs such as TRICARE and CHAMPVA. Also see quality assurance (QA) and quality improvement (QI) .