A group of doctors who work together to manage patient care. Health care reform law offers incentives for doctors to form Medicare ACOs starting in 2012.

Certification that an organization meets the reviewing organization's standards. Examples: accreditation of HMOs by the National Committee on Quality Assurance (NCQA) or accreditation of hospital [..]

An employee must work for the employer on a regular basis in the usual course of the employer's business to be considered an active, full-time employee and eligible for coverage. Usually, a minim [..]

The administrative procedure used to process a claim for service according to the coverage.

An arrangement in which an employer contracts with a third party, typically a health care carrier, to administer the health care plan for the employer who assumes the benefit plan claim risk.  In an A [..]

Advanced radiological imagingHighly technological radiology procedures performed in an office or hospital-like setting.

The health care professional's billed charge or primary carrier's negotiated fee.

An organization offering a "non-traditional" ("not like a hospital") setting for giving birth. Alternative birthing centers can range from free-standing centers to special areas wi [..]

A dental filling material, composed of mercury and other minerals, used to fill decayed teeth.

A general term for care that doesn't involve admission to an inpatient hospital bed. Visits to a doctor's office are a type of ambulatory care.