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13-Oct-2017 03:56

Unlike chronic care, acute care is often necessary for only a short time.

The ability of a patient to take their medication or follow a treatment protocol according to the directions for which it was prescribed; a patient taking the prescribed dose of medication at the prescribed frequency for the prescribed length of time. A credit or debit amount appearing at the carrier/group level on claims and administrative fee invoices sent to plan sponsors or at a claim level on adjustment advice sent to pharmacies.

Its mission is to be the most valued and effective advocate for the PPO Industry by: educating and informing the federal and state legislative and regulatory bodies, promoting PPO Industry best practices, advancing the business needs of Preferred Provider Networks and Payers, and promoting Preferred Provider Networks and PPO benefit products to purchasers, consumers, employers and the healthcare industry at large.

For additional information, go to A patient’s ability to obtain medical care determined by the availability of medical services, their acceptability to the patient, the location of health care facilities, transportation, hours of operation, and cost of care.

Approval usually is used to describe treatments or procedures that have been certified by utilization review.

Can also refer to the status of certain hospitals or doctors, as members of a plan.

Medicare pays health plans 95 percent of the AAPCC, adjusted for the characteristics of the enrollees in each plan.

The leading national association of preferred provider organizations (PPOs) and affiliate organizations, and was established in 1983 to advance awareness of the benefits — greater access, choice and flexibility — that PPOs bring to American health care.

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The lead Federal agency charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans.Health services provided without the patient being admitted. The services of ambulatory care centers, hospital outpatient departments, physicians' offices and home health care services fall under this heading provided that the patient remains at the facility less than 24 hours. Average price paid to a pharmaceutical manufacturer by wholesalers for drugs distributed to retail pharmacies, net of prompt-pay (“cash”) discounts.AMP was a benchmark created by Congress in 1990 in calculating rebates owed Medicaid by pharmaceutical manufacturers.It is the Centers for Medicare & Medicaid Services’ (CMS's) best estimate of the amount of money care costs for Medicare recipients under fee-for-service Medicare in a given area.

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The AAPCC is made up of 122 different rate cells; 120 of them are factored for age, sex, Medicaid eligibility, institutional status, and whether a person has both part A and part B of Medicare.

AHRQ supports health services research that will improve the quality of health care and promote evidence-based decision-making.



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