Dental care that promotes oral health and prevents oral disease and injury.

Services provided to prevent the occurrence of illness, injury, and disease such as vaccine immunizations, antiseptic measures, regular exercise, routine physical examinations, and screening programs for detection of signs of disorders.

CPT codes (99381-99397 and 99401-99429) used when billing for medical services provided to prevent the occurrence of illness or injury.

Health care to keep an individual healthy or to prevent illness (e.g., Papanicolaou tests, pelvic examinations, influenza shots, screening mammograms).

In the medical field, this relates to a patient who has had prior hospitalization, medical services, or surgery. This information is in a system that is used to check claims before approval is given to the provider of the service.

Method of cost containment that freezes physician and hospital fees to try to curtail inflation.

1. Individual who reviews services, procedures, diagnoses, fee schedules, and other data and establishes the amount for a medical service or supply. Also called repricer. 2. Software package in an insurance claims processing system, specific to certain benefits, which analyzes specific data and determines the amount for a medical service or supply. Subsequently, other criteria are applied to establish the actual allowance or payment amount. It is most often used under prospective payment systems.

Principle that is presumed to be true unless there is evidence given to disprove the presumption.

Standard premium rate recommended by state government regulators for a contributory group creditor insurance policy.

1. First time a patient seeks medical care from a provider. 2. Basic health care attention when a patient first contacts someone to care for simpler and more common illnesses and injuries. Primary care can be provided by a family practitioner, pediatrician, or internist and health professionals such as nurse practitioners or physician assistants.