A typical insurance provision whereby responsibility for primary payment for medical services is allocated among carriers when a person is covered by more than one employer-sponsored health benefit program. This coordination prevents duplicate reimbursement for the same medical services.

B

Patients' ability to obtain necessary health services.

One term for the competing health plans forged under managed competition. Published data on the performance of each plan would allow consumers and employers to select the best plan.

Health care provided to treat conditions that are short term and episodic in nature.

The phenomenon of the enrollment of a disproportionate percentage of persons who are poorer risks—

A plan requiring all payers of health care bills—

Health services rendered in a hospital outpatient facility, a clinic, or a physician's office; often synonymous with the term outpatient care.

Supplemental services provided with medical or hospital care.

A process whereby the provider bills a patient for the difference between the provider's charge and the amount of payment already received by the provider from a third party payer other than for co-pays, co-insurance or deductibles.