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Associate practice
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Physicians agree to share expenses of a facility
a legal agreement in which physicians agree to share a facility and staff but do not, as a rule, share responsibility for the legal actions of each other (4) |
Capitation rate
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A fixed monthly fee paid by an HMO to health care providers for providing medical services to patients who are members of that HMO (4)
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Certification
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A voluntary credentialing process usually offered by a professional organization (40
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Copayment
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An agreed upon fee paid by the insured for certain medical services; usually $10 to $20 (4)
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Corporation
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A a type of medical practice, as established by law, which is managed by a board of directors
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Diagnostic related groups ("DRGs)
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Designations used to identify reimbursement ;per condition in a hospital ; used for Medicare patient
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Exclusive provider organization (EPO)
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Exclusive provider organization
a type of managed care that combines the concepts of the HMO and PPO |
Fee splitting
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An agreement to pay a fee to another physician or agency for the referral of patients this illegal in some states and is considered to be an unethical medical practice
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Fixed payment plan
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A payment plan for medical bills that offers subscribers (members) complete medical care in return for a fixed monthly fee
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National :Practitioner Data Bank (NPDB)
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A listing of names that assists with peer review of physicians
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Franchise
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A business run by an individual to whom a franchisor grants the exclusive right to market a product or service in a certain market area
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Gatekeeper
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The person, such as a primary care physician, aor entity, such as an insurance company, that approves patient referrals to other physicians or services.
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Group practice
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Three or more physicians who share the same facility and practice medicine together
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Health Care Quality Improvement Act
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Provides for peer review of physicians by other physicians and by other physicians and healthcare professionals
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Health maintenance organization (HMO)
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Health maintenance organization
a type of managed care plan that offers a range of health services to plan members for a predetermined fee per member by a limited group of providers |