Also known as risk control insurance, a practice allowing an insurance company to transfer a portion of its risks to another insurer (the reinsurer). This practice does not affect policyholder rights in any way, and the original insurer remains liable to the...
An index that assigns weights to each medical service; the weights represent the relative amount to be paid for each service. To calculate a fee for a particular service, the index for that service is multiplied by a constant dollar amount (known as the conversion...
An assessment of the quality of care delivered by health plans, hospitals or physicians. For example, report cards provide information on how well a health plan treats its members, keeps them healthy and provides access to needed care. Report cards can be published by...
The way Medicare determines how much it will pay physicians, based on the resource costs needed to provide a Medicare-covered service. The RBRVS is calculated using three components: physician work, practice expense and professional insurance. The Medicare payment to...