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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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