Doughnut hole

Also spelled donut hole . Another name for the step in a Medicare Part D plan in which the patient pays all of the expenses for eligible drugs until he or she has spent $3850. Also referred to as coverage gap or The gap .

Down time

Period during which a computer, communications line, or other device is malfunctioning or not operating correctly because of mechanical or electronic problems.

Downcoding

1. Coding system used by the physician’s office does not match the coding system used by the insurance company receiving the claim. The insurance company computer system converts the procedure code submitted to the closest code in use, which is usually down one level from the submitted code, generating decreased payment. Sometimes downcoding may occur when the diagnosis code does not support the level of care. 2. Selecting procedure codes at a lower level than the medical service requires or documentation supports. Also called undercoding . Also see penalized claim.

Dr. William Haddon, Jr’s Energy release theory for Loss Control

Accidents are the result of out-of-control energy putting more stress on a structure (including the human body) than that structure can tolerate without damage. From this concept of accident causation, preventing or minimizing accidental losses centers upon attempts to identify conditions which produce inadequately controlled energy, or methods of safeguarding structure against such energy.