- A system designed to improve health care and reduce costs by coordinating medical services and patient treatment through a case manager. The case manager will cost-effectively oversee the assessment and assignation of treatment, plans of action and/or care for clients.
case worker, cost assessment, treatment supervisor, medical adjudicator
Related Terms and Acronyms
- Disease Management (DM) — Acronym, Important,
➥ Heath care decisions made to manage a disease.
- The process of discussing and agreeing to treatments and care plans for individuals with long-term health care needs.
- Gatekeeper — Definition,
- In relation to health maintenance organizations, a gatekeeper is a primary care physician that arranges medical care for policyholders.
- Medical Specialist — Definition,
- A doctor with training in a specific medical field.
- Point of Service Plan — Definition,
- A health insurance plan that combines the features of both health maintenance organizations and preferred provider organizations.
- Pre-existing Condition (PRE-X) — Acronym,
- A medical condition that's occurrence precedes the writing of an insurance policy.
- Preferred Provider Organization (PPO) — Acronym,
- A health care program that gives its members a level of freedom and independence when choosing health care options.
- Primary Care Physician — Definition,
- A doctor who administers or arranges the majority of an individual's health care needs.
- Usual, Customary and Reasonable Fees — Definition,
- The expected cost of a medical treatment, and what an insurance company is willing to pay.