The Patient Protection and Affordable Care Act (PPACA) – also known as the Affordable Care Act or ACA – is… Read more
Supervising the details and routine activities of installing and running a health plan, such as answering questions, enrolling individuals, billing… Read more
See Obamacare metal plans.
Also called pre-certification review, or pre-admission review. Approval by a case manager or insurance company representative (usually a nurse) for… Read more
A review of an individual’s health care status or condition, prior to an individual being admitted to an inpatient health… Read more
A pre-existing condition is a medical condition that is excluded from coverage by an insurance company because the condition was… Read more
Medical tests that are completed for an individual prior to being admitted to a hospital or inpatient health care facility.
A preferred provider organization (PPO) is a managed care organization of health providers who contract with an insurer or third-party… Read more
Premium assistance tax credits – usually just called premium subsidies – are included in the health reform legislation to help… Read more
Beginning in 2014, millions of Americans will discover that they qualify for Affordable Care Act premium subsidies designed to help… Read more
A health care professional (usually a physician) who is responsible for monitoring an individual’s overall health care needs. Typically, a… Read more
A private exchange is simply an online resource set up by brokers, insurance carriers or benefit consultants, where individuals and… Read more
Private health insurance – plans marketed by the private health insurance industry – currently dominates the U.S. health care landscape, with… Read more
Provider is a term used for health professionals who provide health care services. Sometimes, the term refers only to physicians.… Read more
The ACA included a provision to set up a public exchange in every state, run by either the state, HHS,… Read more
A public option – also referred to as a public plan – was a proposal within the health reform legislation that would… Read more