Chapter 2- Medical Practice Management

Bond
An insurance contract by which a bonding agency guarantees payment of a specified sum to an employer in the even of a financial loss to the employer caused by the act of a specified employee; a legal obligation to pay specific sums.
Capitation
Heath-car providers are paid a fixed monthly compensation for a range of services for each health maintenance organization (HMO) member in their care.
Complementary Medicine
The practice of medicine that complements traditional medicine with alternative medicine.
Conglomerate
A corporation of a number of different companies operating in a number of different fields.
Co-payment
A medical expense that is a member’s responsibility; usually a fixed amount of $25 or highter.
Deductible
A cost-sharing arrangement in which the member pays a set amount toward covered services before the insurance carrier begins to make any payments.
Fee-for-service
Pays providers for each service performed.
Gatekeeper
A term referring to managed care primary care providers responsible for referring members to specialists (usually with the same plan) with the intent of matching the client’s needs and preferences with the appropriate and cost-effective use of those specialists’ services.
Group Practice
Type of business management in which three or more individuals organize to render professional service and share the same equipment and personnel.
Health Maintenance Organization (HMO)
A type of managed care plan offering health-care services from participating physicians and providers to an enrolled group of persons for a predetermined fee per member.
Integrative Medicine
the practice of medicine that accounts for the whole person (body, mind, spirit, and lifestyle) using all appropriate therapies, both traditional and alternative.
Joint Venture
A type of business management formed by hospitals, physicians and other providers, and clinics to offer client care.
Managed Care
A type of health-care plan; generally one of two types, namely HMO or preferred provider organization (PPO)
Opt-out option
Members or clients can seek treatment from providers outside the health-care plan but pay more to do so.
Partnership
Type of business management involving the association of two or more individuals who are co-owners of their business.
Pay for performance P4P
A type of managed care that encourages providers to improve the quality of their clients’ care; reimburses them for their progress towards a fixed goal.
Preferred provider Organization (PPO)
A type of business agreement between a medical service provider and an insurer organization in which the fees for specific services are predetermined for an already established group of clients assigned to or selected by the provider
Professional Service Corporation
Specific type of corporation in which licensed individuals organize to render a professional service to the public. Such licensed individuals include physicians, medical providers, lawyers, and dentists.
Sole Proprietorship
Type of business management owned by a single individual.