HHS is the acronym for the Department of Health and Human Services. It is the U.S. government’s principal agency for protecting and regulating the health of all Americans and for providing essential human services. It has jurisdiction over 11 operating divisions and regulatory agencies including: Administration of Children and Families (ACF); Administration on Aging (AoA); […]
A single-payer system is a health care system in which one entity collects all health care fees and pays all health care costs. Generally, single-payer systems are operated and regulated by the government, which sets the rules and decides what gets paid.
The FDA is the acronym for the Food and Drug Administration. It falls under the jurisdiction of the Department of Health and Human Services (HHS). It is responsible for protecting and advancing the public???s health and securing the nation???s food supply as well as monitoring and approving the safety of prescription drugs and medical devices.
Self-pay means that the patient pays completely out of pocket for his or her medical care and is therefore often paying the full retail price for health care, unless a hospital or doctor provides a sliding scale. Self-pay individuals pay much more than those with health benefits because they do not have the clout or […]
The CDC is the acronym for the Centers for Disease Control and Prevention. It is the nation???s top public health agency and one of the main components of the Department of Health and Human Services (HHS). Based in Atlanta, Ga., it works to protect the health of people and communities by identifying and preventing potential […]
COBRA is the acronym for the Consolidated Omnibus Budget Reconciliation Act of 1986. According to the U.S. Department of Labor, the landmark legislation provides for continuation of group health coverage that otherwise might be terminated. COBRA provisions give certain former employees, retirees, spouses, former spouses and dependent children the right to temporary continuation of their […]
NIH is the acronym for the National Institutes of Health. It is part of the U.S. Department of Health and Human Services (HHS), and it serves as the nation???s medical research agency. NIH is the largest source of funding for medical research in the world, awarding grant money to universities and research centers in the […]
Medical underwriting is the process used by insurance companies to determine whether to offer an individual health care coverage and how much a policy premium will cost. It also can be used to determine coverage exclusions or limits.
Preadmission certification is preapproval by a health insurance company or employer-sponsored plan for an individual???s admittance to a hospital. If precertification is not obtained for a non-emergency procedure, the insurance provider may pay for some of the services received or may not pay for any of the services.
Private health insurance is coverage by a health plan provided by an employer or purchased by an individual from a private health insurance company.
Charity care is free or discounted health care provided by a hospital. The people who receive this care generally do not qualify for either Medicaid insurance for the poor or Medicare insurance for the elderly, or they do not have insurance.
Coinsurance is the money a patient must pay after a deductible has been paid. It is generally specified by a percentage of a retail price. For example, an employee may pay 10 percent for a service while the insurance company or employer pays 90 percent. Many drug companies also use coinsurance in part to make […]
Group health insurance is insurance coverage offered through an employer or other entity that covers all individuals in the group.
HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996. Known primarily as the health privacy law, it provides federal protections for personal health information held by covered entities and gives patients a large number of rights as far as how that information is shared.The law also protects an individual’s ability […]
A primary care physician is a physician who handles the primary and general outpatient care needs of patients. Primary care physicians can be family physicians, internists, pediatricians and obstetrician-gynecologists. Primary care physicians tend to make less money than specialists, though they see more patients, but salary surveys show primary care physicians are taking on a […]
A specialist focuses on a more narrow area of medical care such as a neurologist, a cardiologist, an oncologist or an otolaryngologist.
A subspecialist is a doctor who has a narrower area of expertise in a specialized area. For example, a pediatric oncologist is a doctor who takes care of children with cancer, and a geriatric oncologist is a doctor who takes care of elderly people with cancer.
A waiting period is the amount of time an individual or dependent must wait before insurance coverage becomes effective.
Ambulatory care refers to medical services that are provided on an outpatient basis, such as at an urgent care center, certain clinics and health centers. According to the Department of Health and Human Services (HHS), the term ambulatory care implies that the patient must travel to a location to receive services that do not require […]
An electronic medical record is a digital medical record of a patient???s health maintained by the patient???s physician as a record of the physician???s care for the patient. A patient must be able to leave an office with an electronic copy of his or her medical record.
The out-of-pocket maximum or limit is the maximum amount a person will have to pay for covered services in a year. Generally, this includes copayments, coinsurance and deductibles, though it may vary from insurance plan to insurance plan.
An outpatient is an individual who receives health care services on an outpatient basis, meaning the person does not stay overnight in a hospital or inpatient facility. These services can include diagnosis, treatment and surgery.
A nurse practitioner is a licensed health professional with an advanced degree who has the ability to perform basic primary care functions such as prescribing medication and making certain diagnoses. Regulations for their job duties, known as ???scope of practice??? rules, vary from state to state. They do have to have some physician supervision, but […]
A pre-existing condition is any condition (physical or mental) including a disability that a patient was diagnosed with or received treatment for before their health insurance plan went into effect. Some states have pre-existing condition exclusions, such as six months or 18 months. The time an insurance company is allowed to exclude a patient varies […]