|
[ A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z ]
I . . .
Incurred But Not Reported (IBNR)
Refers to claims which reflect services already delivered, but,
for whatever reason, have not yet been reimbursed. These are bills
"in the pipeline." This is a crucial concept for proactive
providers who are beginning to explore arrangements that put them
in the role of adjudicating claims--as the result, perhaps, of
operating in a sub-capitated system (see below). Failure to account
for these potential claims could lead to some very bad decisions.
Good administrative operations have fairly sophisticated mathematical
models to estimate this amount at any given time.
Indemnify
To make good a loss.
Indemnity Carrier
Usually an insurance company or insurance group that provides
marketing, management, claims payment and review, and agrees to
assume risk for its subscribers at some pre-determined rate.
Indemnity Plan or Indemnity Health Insurance
A plan which reimburses physicians for services performed, or
beneficiaries for medical expenses incurred. Such plans are contrasted
with group health plans, which provide service benefits through
group medical practice.
Independent Practice Association (IPA)
A health maintenance organization delivery model in which the HMO
contracts with a physician organization, which, in turn, contracts with
individual physicians. The IPA physicians practice in their own offices
and continue to see fee-for-service patients. The HMO reimburses the
IPA on a capitated basis; however, the IPA usually reimburses the
physicians on a fee-for-service basis. This type of system combines
prepayment with the traditional means of delivering health care.
Individual Plans
A type of insurance plan for individuals and their dependents
who are not eligible for coverage through an employer group (group
coverage).
Individual Practice Association (IPA)
An HMO model in which the HMO contracts with a physician organization
that in turn contracts with individual physicians. The IPA physicians
provide care to HMO members from their private offices and continue
to see their fee-for-service patients.
Inpatient Care
Care given a registered bed patient in a hospital, nursing home
or other medical or post acute institution.
Inpatient Services
Inpatient hospital services are items and services furnished to an
inpatient of a hospital by the hospital; including bed and board,
nursing and related services, diagnostic and therapeutic services,
and medical or surgical services.
Internal Medicine
Generally, that branch of medicine that is concerned with diseases
that do not require surgery, specifically, the study and treatment
of internal organs and body systems; it encompasses many subspecialties;
internists, the doctors who practice internal medicine, often
serve as family physicians to supervise general medical care.
International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
A coding scheme used to document the incidence of disease, injury,
mortality and illness.
[ A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z ]
| 