| Accreditation |
| The formal evaluation of an organization or a program by an external body according to certain pre-determined standards. The process is often carried out by a private organization created for the purpose of assuring the public of the quality of an institution or program. For example, the National Committee for Quality Assurance, a nationally recognized independent organization, evaulates managed care plans using objective, scientific measures. See also NCQA. |
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| Accreditation Association for Ambulatory Health |
| The Accreditation Association for Ambulatory Health Care, also known as the Accreditation Association or AAAHC, was formed in 1979 to assist ambulatory health care organizations in improving the quality of care provided to patients. The AAAHC is the leader in ambulatory health care accreditation. |
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| Accreditation Commission for Health Care (ADHC) |
| The Accreditation Commission for Health Care, Inc. (ACHC) is one of the few standard-setting accrediting bodies for home care and alternate site organizations in the country. Their accrediting programs were developed by providers for providers to reflect criteria conducive to providing quality care. ACHC is a not-for-profit organization that has been a symbol of quality since 1986. |
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| Agent/Broker |
| Individual who sells and services insurance policies in either two classifications:
1. Independent agent represents at least two insurance companies and (at least in theory) services clients by searching the market for the most advantageous price for the most coverage. The agent's commission is a percentage of each premium paid and includes a fee for servicing the insured's policy.
2. Direct or career agent represents only one company and sells only its policies. This agent is paid on a commission basis in much the same manner as the independent agent. |
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| American Board Internal Medicine (ABIM) |
| The American Board of Internal Medicine (ABIM) has a maintenance-of-certification program, which sets standards and certifies physicians who practice internal medicine and its sub-specialties, such as cardiology, endocrinology and geriatrics. |
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| American Board of Family Medicine (ABFM) |
| The American Board of Family Medicine (ABFM) is the second largest medical specialty board in the United States. Founded in 1969, it is a voluntary, not-for-profit, private organization whose purposes include: improving the quality of medical care available to the public, establishing and maintaining standards of excellence in the specialty of Family Medicine, improving the standards of medical education for training in Family Medicine, and determining by evaluation the fitness of specialists in Family Medicine who apply for and hold certificates
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| American Board of Medical Specialties (ABMS) |
| Established in 1933, the American Board of Medical Specialties (ABMS), a not-for-profit organization comprising 24 medical specialty Member Boards, is the pre-eminent entity overseeing the certification of physician specialists in the United States. The primary function of ABMS is to assist its Member Boards in developing and implementing educational and professional standards to evaluate and certify physician specialists. By participating in these initiatives, ABMS also serves as a unique and highly influential voice in the health care industry, bringing focus and rigor to issues involving specialization and certification in medicine. ABMS is a designated primary equivalent source of credential information. |
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| American Osteopathic Board (AOB) |
| The Bureau of Osteopathic Specialists of the American Osteopathic Association (AOA) is made up of eighteen different specialty boards who implement the below certification criteria:
define the qualifications required of osteopathic physicians for certification in the specialty or field of practice that may be assigned to the Board, determine the qualifications of osteopathic physicians for certification in specialty or field of practice that may be assigned to it, conduct examinations in conformity with the Bylaws of this Board, issue certificates subject to the approval of the Bureau of Osteopathic Specialists of the AOA, to those osteopathic physicians who are found qualified, recommend revocation of certificates for cause, and use every means possible to maintain a high standard of practice within the osteopathic profession.
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| American Osteopathic Board of Orthopedic Surgery |
| The American Osteopathic Board of Orthopedic Surgery was established in 1979 and exists primarily for the purpose of assisting newly trained orthopedic surgeons in the certification process. The purpose of certification examination is to provide the public with a dependable mechanism to identify physicians who have met a standard to assure competent performance in the field of orthopedic surgery. |
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| Ancillary Services |
| Additional charges or secondary services from a non-attending provider. Example: anesthesia, x-rays, labs.
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| Approved Amount |
| The lesser amount between the billed charge and the maximum payment for the covered service. Any required copayments and deductibles are subtracted from this amount before payment is made. |
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