Psychiatrist, social worker, psychiatric nurse, psychiatric hospital, or other institution for mental disease that is licensed to render mental health services.

Insurance payer phrase for health care services given to members of a managed care or private plan for emotional problems or chemical dependency.

Any type of illness in which psychological syndrome, intellectual, emotional, or behavioral dysfunction is the main feature.

Disorder characterized by significantly below average general intellectual function with deficits or impairments in the ability to learn and to adapt socially. The cause may be genetic, biological, psychosocial, or traumatic.

Guide or teacher who offers advice, criticism, wisdom, guidance, and perspective to an inexperienced but promising protégé to help reach a life goal.

Agent or third party that conveys to purchasers information obtained individually from providers in the network about the prices the network participants are willing to accept and conveying to providers any contract offers made by purchasers. Each provider then makes an independent, unilateral decision to accept or reject each contract offer.

1. Process by which tumor cells spread to distant parts of the body. 2. Tumor that develops away from the site of origin.

Alternative payment system for dialysis services. If a patient selects method I, the facility rendering the dialysis care assumes responsibility for giving home dialysis equipment, supplies, and home support services. The facility receives payment under the composite rate system. The patient pays the Medicare Part B deductible and coinsurance at the facility’s composite rate.

Alternative payment system for dialysis services. If the patient selects method II, the patient contacts the supplier of the home dialysis equipment and supplies and not a dialysis facility. The patient has only one supplier and pays the Medicare Part B deductible and coinsurance. The dialysis facility may not be paid for home dialysis equipment or supplies under this reimbursement system. The facility only receives method II payment for home dialysis support services.