Dental Plans Applications
Anthem Blue Cross of California
Dental Blue Application
HMO Application
PPO Application
Senior HMO Application
Senior PPO Application
SmileNet Application
Blue Shield
Application
Delta Dental MorganWhite
Online Application
Application
Golden West
Application
Kaiser Permanente
Application
Standard Life MorganWhite
Application

 

 

Glossary of Health Plans

 

A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z

National Accounts NCH NCQA
National Council NDC National Health Insurance
NPDB National Provider Identifier NICU
Network Network Model HMO Network Provider
NMHPA New Business Underwriting No Balance Billing Provision
Non-Group Market Non-Maleficence Non-Participating Physician
Nosocomial Infections NPLANID Nurse Practitioner

National Accounts - Large group accounts that have employees in more than one geographic area that are covered through a single national agreement for health coverage.

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National Claims History System (NCH) - A CMS data reporting system that combines both Part A and Part B claims in an ordinary file. The NCH system becoming fully operational in 1991.

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National Committee for Quality Assurance (NCQA) - A non-profit organization formed to improve patient care quality and health plan performance in partnership with managed care plans, purchasers, consumers, and the public sector. The object of NCQA assessment and accreditation is to provide information to purchasers and patients and to encourage plans to compete based on quality and value rather than solely on price and provider network.

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National Council for Prescription Drug Programs - An ANSI-accredited group that maintains a number of standard formats for use by the sell pharmacy industry, some of which have been adopted as HIPAA standards.

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National Drug Code (NDC) - A medical code set to maintain by the Food and Drug Administration that contains codes for drugs that are FDA-approved. The Secretary of HHS adopted this code put as the standard for reporting drugs and biologics on standard transactions.

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National Health Insurance - Proposal by politicians to make government the single payer for all health care, alike to Great Britain or Canada. Providers like some aspects of this thought because it provides for "universal coverage" for all citizens. However, businesses and providers dislike the idea of the government administering a program that they will either have to support or be funded by.

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National Practitioner Data Bank (NPDB) - A automated data bank maintained by the federal government that contains information on physicians against whom malpractice claims have been paid or certain corrective actions have been taken. Hospitals and other agencies pay a fee to contact these records.

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National Provider Identifier - A system for exclusively identifying all providers of health care services, supplies, and equipment. A term planned by the Secretary of HHS as the standard identifier for health care providers.

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Neonatal Intensive Care Unit (NICU)- A hospital unit with special equipment for the care of early and seriously ill newborn infants.

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Network - An affiliation of providers through official and informal contracts and agreements. Networks may contract externally to obtain administrative and financial services. A list of physicians, hospitals and other providers who give health care services to the beneficiaries of a specific managed care organization.

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Network Model HMO - This kind of HMO contracts with more than one physician group and may contract with single or multi-specialty groups as well as hospitals and other health care providers. A health plans that contract with multiple physician groups to deliver health care to members.

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Network Provider - A doctor, hospital or other medical professional who has been accepted to participate in a health plan's provider network.

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Newborns' and Mothers' Health Protection Act (NMHPA)- A law which specify that group health plans or group healthcare insurers cannot permission that hospital stays following childbirth be shorter than 48 hours for normal deliveries or 96 hours for cesarean births.

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New Business Underwriting - The risk estimation an MCO performs when it first issues coverage to a group.

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No Balance Billing Provision - A provider contract section which states that the provider agrees to accept the amount the plan pays for medical services as payment in full and not to bill plan members for additional amounts.

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Non-Group Market - A market section that consists of customers who are covered under an individual contract for health coverage or enrolled in a government program.

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Non-Maleficence - An ethical principle which, when applied to manage care, states that managed care organizations and their providers are obligated not to harm their members.

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Non-Participating Physician (or Provider) - A provider, doctor or hospital that does not symbol a contract to participate in a health plan, frequently which requires reduced rates from the provider. In the Medicare Program, this refers to providers who are therefore not compelled to accept assignment on all Medicare claims.

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Nosocomial Infections - Infections that are acquired while a patient is in a hospital are referred to as nosocomial infections; a term resultant from 'nosos' the Greek word for 'disease'. Frequently nosocomial infections become apparent while the patient is still in the hospital but in some cases symptoms may not show up until after the affected patient is discharged.

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NPLANID - A term used by CMS for a planned standard identifier for health plans. CMS had formerly used the terms PayerID and PlanID for the health plan identifier.

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Nurse Practitioner (NP) - A registered nurse qualified and specially educated to provide primary care, including primary health care in homes and in ambulatory care facilities, long-term care facilities, and other health care institutions. Normally, NPs are licensed and have master's degrees. Nurse practitioners generally function under the supervision of a physician but not necessarily in his/her or her presence.

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Standard Health Plans Applications
Aetna
Application
Anthem BC Life and Health Insurance Company Tonik
Online Application
Anthem Blue Cross of California
Online Application
Application
Change of Coverage Form
Blue Shield of California
Application
Health Net of California
Online Application
Application
Health Net of California Farm Bureau
Online Application
Application
Kaiser Permanente
Online Application
Application
Temporary Health Plans Applications
Anthem BC Life and Health Insurance Company
Online Application
Application
Assurant
Application
Health Net of California
Online Application
Application
Health Plans
Kaiser Copayment Plans
Kaiser Deductible HMO Plans
Kaiser HSA-Qualified Deductible HMO Plans
Anthem Blue Cross Blue Shield
PacifiCare
Health Insurance
Dental Plans
Long Term Insurance
Kaiser
PPO Plans
Workers Pension

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