Key Concepts
Ambulatory Surgery - Surgery performed on an outpatient basis.
Case Management - The professional arrangement and coordination of health services through assessment, service plan development, and monitoring.
Disability Income Insurance - A type of health insurance coverage that provides for the payment of regular, periodic income should the insured become disabled from illness or injury.
Mandatory Second Opinion - To control costs, many health policies provide that, in order to be eligible for benefits, insureds must get a second opinion before receiving nonlife-threatening surgery.
Medical Cost Management - The process of controlling how policyholders utilize their policies.
Medical Expense Insurance - Pays benefits for nonsurgical doctors' fees commonly rendered in a hospital; sometimes pays for home and office calls.
Precertification - The insurer's approval of an insured's entering a hospital. Many health policies require precertification as part of an effort to control costs.
Premium Factors - Morbidity, interest, and expenses.
Risk Factors - Physical condition, moral hazards, and occupation.
Substandard Risk - Person who is considered an under-average or impaired insurance risk because of physical condition, family or personal history of disease, occupation, residence in unhealthy climate or dangerous habits.
Familiarize yourself with the Key Concepts in the Florida study manual, Unit 23.
