Health plan that contracts straight to private practice physicians or provider groups in a locale rather than through an intermediary or managed care company (e.g., open panel health maintenance organization [HMO]).
Tag: USA
Direct contracting
See: direct contract model .
Direct cost
Dollar value that is related to a given object or specific service (e.g., medical equipment or medical supplies).
Direct costs
See: out-of-pocket expenses (OOPs) .
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Costs that vary directly with the amount of business transacted.
Direct data entry
Under the Health Insurance Portability and Accountability Act (HIPAA), this is the access of data directly into the computer through machine-readable source documents or through the use of online terminals that is immediately transmitted into a health plan’s computer.
Direct deposit
Monies electronically sent to an account in a financial institution (i.e., bank, trust company, savings and loan association, brokerage agency, or credit union).
Direct pay
1. System of billing members or subscribers of insurance policies for the premium payments, and they pay directly to their health plans. Direct pay rates are usually higher than group rates. Also called billed direct or billed-at-home . 2. Phrase used when the patient pays straight to the physician or health care provider for medical services rendered.
Direct payment subscriber
Individual enrolled in a managed care plan who pays premiums to the plan instead of through a group. Usually, payment is higher and benefits are not as wide ranging as the subscriber enrolled and paying as a member of the group.
Direct placement
Sale of a whole issue of bonds or stock to one or two large institutional clients without them being offered publicly.
Direct premiums
Property or casualty insurance premiums that are collected by the insurance company from the insured, before reinsurance is ceded to, or accepted from, another company.
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Premiums collected from policyholders before premiums for reinsurance are paid.