Medical Terms
To evaluate a person’s medical, behavioral, or educational condition to determine what services the person needs.
What is Assess?
A small amount (less than the whole bill) you must pay when you visit a healthcare provider.
What is a Co-payment?
A form that you sign giving permission for one health or educational provider to share information with another provider or organization.
What is a Release of Information (ROI)?
Treatments that are considered by medical providers to be appropriate for treating a person’s symptoms.
What is Medically necessary?
A care provider whose services are not on the list of a certain insurance company’s contracted providers; this means the insurer may not cover the bill or cover less of the bill.
What is Out-of-network?
The span of care options (different types of care), ranging from a simple office visit to full inpatient hospital treatment.
What is a Continuum of Care?
Signs of disease that may include physical changes, thoughts, feelings, and behaviors.
What are Symptoms?
Types of treatment insurance will not pay for under certain conditions.
What is are Exclusions?
Approval from a health plan that may be required before you get a service or fill a prescription.
What is Pre-authorization?
Physical changes, thoughts, feelings, or behaviors that cause problems with activities and daily living.
What are Disorders?
A primary care provider’s order that will allow you to see a specialist under the terms of your health insurance plan.
What is a Referral?
A collaborative process to plan, seek, advocate for, and monitor services for health and human service needs.
What is Case management?
The process of examining a person’s condition or behavior to determine (find out) the problem.
What is an Evaluation?
The amount you pay for your health insurance every month.
What is the Premium?
The deliberate organization of patient care activities between two or more participants involved in a patient’s care to facilitate the appropriate delivery of healthcare services.
What is Care coordination?