Licensure
A mandatory credentialing process established by law, usually at the state level, that grants the right to practice certain skills and endeavors
Certification
A voluntary credentialing process whereby applicants who meet specific requirements may receive a certificate
Registration
A credentialing procedure whereby one's name is listed on a register as having paid a fee and/or met certain criteria within a profession
Accreditation
Official authorization or approval for conforming to a specific standard, for health care education programs, health care facilities, and managed care plans
Reciprocity
The process by which a professional license obtained in one state may be accepted as valid in other states by prior agreement without reexamination
Allopathic
Means "different suffering" and refers to the medical philosophy that dictates training physicians to intervene in the disease process, through the use of drugs and surgery
osteopathic doctors
trained to emphasize the musculoskeletal system of the body and the correction of joint and tissue problems
Medical practice acts
State laws written for the express purpose of governing the practice of medicine
Medical boards
bodies established by the authority of each state's medical practice acts for the purpose of protecting the health, safety, and welfare of health care consumers through proper licensing and regulation of physicians and other health care practitioners
Sole proprietorship
A form of medical practice management in which a physician practices alone, assuming all benefits and liabilities for the business
Group practice
A medical management system in which three or more licensed physicians share the collective income, expenses, records, and personnel for the business
Associate practice
A medical management system in which two or more physician share office space and employees but practice individually
partnership
A form of medical practice management system whereby two or more parties practice together under a written agreement specifying the rights, obligations, and responsibilities of each partner
Professional corporation
A body formed and authorized by law to act as a single person
Managed care
A system in which financing, administration, and delivery of health care are combined to provide medical services to subscribers for a prepaid fee
Health maintenance organization (HMO)
A health plan that combines coverage of health care cost and delivery of health care for a specific payment
Coinsurance
Amount of money insurance plan members must pay out of pocket, after the insurance plan pays it's share
Copayment
flat fees that insurance plan subscribers pay for certain medical services
Individual practice association (IPA)
a type of HMO that contracts with groups of physicians who practice in their own offices and receive a per-member payment from participating HMO's to provide a full range of health services for members
Preferred provider organization (PPO)
A network of independent physicians, hospitals, and other health care providers who contract with an insurance carrier to provide medical care at a discount rate to patients who are part of the insurer's plan. Also called preferred provider association (P
Physician hospital organization (PHO)
A health care plan in which physicians join with hospitals to provide a medical care delivery system and then contract for insurance with a commercial carrier or an HMO
Primary care physician (PCP)
The physician responsible for directing all of a patient's medical care and determining whether the patient should be reffered for specialty care
Accountable care organization (ACO)
A health care payment and delivery model that could reward doctors and hospitals for controlling costs and improving patient outcomes by allowing them to keep a portion of what they save if standards of quality are met
Health insurance portability and accountability act (HIPAA) 1996
A federal statute that helps workers keep continuous health insurance coverage for themselves and their dependents when they change jobs, protects confidential medical information from unauthorized disclosure or use, and helps curb the rising cost of frau
Telemedicine
Remote consultation by patients with physicians or other health professionals via telephone, closed-circuit television, or the internet
Patient portal
A secure online Web site that gives patients 24-hour availability to health care providers