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T . . .

Tertiary Care
One of the following:

  • Services provided by highly specialized providers such as neurosurgeons, thoracic surgeons and intensive care units. These services often require highly sophisticated technology and facilities.
  • Subspecialty care usually requiring the facilities of a university affiliated or teaching hospital that has extensive diagnostic and treatment capabilities.

Third Party Administrator (TPA)
One of the following:

  • Organizations with expertise and capability to administer all or a portion of the claims process.
  • Individual or company that contracts with employers who want to self-insure the health of their employees. They develop and coordinate self-insurance programs, process and pay the claim and may help locate stop-loss insurance for the employer. They also can analyze the effectiveness of the program and trace the patterns of those using the benefits.

Third-Party Payment
One of the following:

  • Payment by a financial agent such as an HMO, insurance company or government rather than direct payment by the patient for medical care services.
  • The payment for health care when the beneficiary is not making payment, in whole or in part, in his own behalf.

Total Budget
Otherwise known as a "global" budget, a cap on overall health spending.

Transfer
Movement of a patient between hospitals or between units in a given hospital. n Medicare, a full DRG rate is paid only for transferred patients that are defined as discharged.

Treatment Episode
The period of treatment between admission and discharge from a modality, e.g., inpatient, residential, partial hospitalization, and outpatient. Many healthcare statistics and profiles use this unit as a base for comparisons.


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