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| Providers of medical services agreeing that the receipt of payment from Medicare for a professional service will constitute full payment for that service. |
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| Recognition that a health care organization has met an official standard. |
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| Level of health care, generally provided in hospitals or emergency departments, for sudden, serious illnesses or trauma. |
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| Term applied to a physician who admits and is responsible for a hospital patient. |
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| Payment method whereby the provider of care receives a set dollar amount per patient, regardless of services rendered. |
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| Health care professional and expert in managed care who assists patients in assessing health and social service systems to ensure that all required services are obtained; coordinates care with doctor and insurance companies. |
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| Coverage a Medicare beneficiary has after reaching a certain amount of "out of pocket" monies paid for their medications during the temporary coverage gap. The beneficiary will pay a coinsurance amount (like 5% of the drug cost) or a copayment ($2.15 or $5.35 for each prescription) for the rest of the calendar year. |
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| Individual in direct charge of a hospital who is responsible to the governing board. |
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| Complementary and alternative health care profession with the purpose of diagnosing and treating mechanical disorders of the spine and musculoskeletal system with the intention of affecting the nervous system and improving health. |
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| Care for illnesses of long duration, such as diabetes or emphysema. |
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| Concerned with the members of a community with emphasis on prevention and early detection of disease. |
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| Sometimes called a "donut hole"; a temporary coverage gap in Medicare that occurs after the beneficiary has accumulated a certain amount of money (no more than $3,850) in total prescription drug expenses. The beneficiary pays 100% of drug costs while in the gap (maximum amount, $3,051.25); then the beneficiary receives catastrophic coverage. |
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| Unskilled care given for the primary purpose of meeting personal needs, such as bathing and dressing. |
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| Classification system used to determine payments from Medicare by assigning a standard flat rate to major diagnostic categories. This flat rate is paid to hospitals regardless of the full cost of the services provided. |
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Definition
| Group of community citizens at the head of the hospital organizational structure. |
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| Health Maintenance Organization |
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Definition
| Organization that has management responsibility for providing comprehensive health care services on a prepayment basis to voluntarily enrolled persons within a designated population. |
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| Equipment and services provided to patient in-home to ensure comfort and care. |
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| Alternative medical system. A belief that "like cures like," meaning that small, highly diluted quanities of medicinal substances are given to cure symptoms, when the samce substances given at higher or more concentrated doses would actually cause those symptoms. |
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| Supportive care for terminally ill patients and their families. |
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| Full-time, acute care specialist who focuses exclusively on hospitalized patients. |
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Definition
| Patient who has been admitted to a health care facility for at least 24 hours for treatment and care. |
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Term
| Integrated Delivery Networks |
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Definition
| Health care organizations merged into systems that can provide all needed health care services under one corporate umbrella. |
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Term
| International Statistical Classification of Diseases and Related Health Problems |
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Definition
| Detailed description of known deseases and injuries. Each disease (or group of related diseases) is described with its diagnosis and is given a unique code, up to six characters long. Published by the World Health Organization. |
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| Award given by the American Nurses' Credentialing Center to hospitals that satisfy a set of criteria designed to measure their strenth and quality of nursing. |
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Definition
| The use of a planned and systematic approach to providing health care, with the goal of offering quality care at the lowest possible cost. |
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Definition
| Federal and state program that provides medical assistance to the indigent. |
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Term
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| Private insurance plan available to Medicare-eligible persons to cover the costs of medical care not covered by Medicare. |
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Definition
| The combining of individual physician practices and small, stand-alone hospitals into larger networks. |
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| Alternative medical system that proposes that there is a healing power in the body that establishes, maintains, and restores health. Treatments include nutrition and lifestyle counseling, nutritional supplements, medicinal plants, exercise, homeopathy, and treatments from traditional Chinese medicine. |
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Definition
| Patient who receives care at a health care facility but is not admitted to the faciltiy for 24 hours. |
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| Sometimes referred to as "gate keepers," these general practitioners are the first physicians to see a patient for an illness. |
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| A graduate of a medical school who is gaining experience in a hospital. |
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| The use of robots in performing surgery. |
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| Nursing interventions. Classification defined as establishing priorities of patient care, usually according to a three-level model: emergent, urgent, and nonurgent. |
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