Employer that offers health insurance coverage to its employees and pays for the medical expenses directly instead of contracting with an insurance company.

Type of group insurance in which a group sponsor, not an insurance company, pays the claims made by group insureds. It may be partially or fully self-insured.

Health insurance in which the employer and not an insurance company is at risk for the employees’ medical expenses.

In CPT coding of a service or procedure, problem that runs a definite and prescribed course, is transient in nature, and is not likely to permanently alter health status or has a good prognosis with management/compliance.

Individual (self) or patient’s family who pays out of pocket for the medical services instead of a third-party payer (insurance company). Self-pay patients may not have health insurance coverage.

In workers’ compensation, health care obtained by an injured worker either before determination of eligibility or after rejection or delay of benefits by the insurance company.

Patient in a managed care plan that refers himself or herself to a specialist, outpatient clinic, emergency department, or hospital outpatient department. The patient may be required to inform the primary care physician.