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Colorado Nonprofit Association

Nonprofit Resources is a wholly owned Subsidiary of Colorado Nonprofit Association

   

Glossary of Terms

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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

Portable: Continuation of a group life insurance policy after the employee is no longer eligible for the group plan. Policy provisions and premiums stay the same

Physical therapist: Assists patients who have experienced disability from illness, trauma, or birth defects. Performs individual exercise programs to restore or relocate physical function.

Point of service (POS): A type of managed care coverage that allows members to receive services either from participating HMO or from providers outside the network.

Pre-admission certification: Review and approval process completed before hospital admission to ensure the medical necessity for the acute level of care and for the proposed services and procedures, to avoid a weekend admission, and to forecast the expected length of stay. The review process may include an assessment of the physician's proposed treatment protocol and fees. Compliance with changes in the treatment plan recommended by the reviewing entity may be a condition of receiving full coverage under the health benefit. The benefit level may be reduced or services not covered at all if the patient fails to comply with plan requirements. The pre-admission review process may also include an administrative confirmation of the patient's eligibility for benefits, covered services and restrictions, and the determination of applicable deductibles, co-payments, and maximums.

Preferred provider organization (PPO): A managed care plan in which patients use doctors, hospitals and providers inside the network. Patients may use facilities outside the network for an additional cost.

Preventive care: Comprehensive care emphasizing priorities for prevention, early detection and early treatment of conditions, generally including routine physical examination and immunizations.

Primary care physician (PCP): A physician designated as responsible to provide specific care to a patient, including evaluation and treatment as well as referral to specialists.

Prior acts coverage: Coverage for all acts that occurred before the policy was issued. Prior acts coverage is one of the means of covering the gap in coverage when switching from a claims-made policy to another claims-made policy or to an occurrence policy. The prior acts coverage is provided by the new policy, as opposed to tail coverage that is added by endorsement to an expired claims-made policy.

Professional liability insurance: Also known as malpractice coverage or errors and omissions (E&O) coverage; covers liability for damages arising from the rendering of or failure to render professional services.

Property insurance: Insurance that covers direct damage to the nonprofit's property and equipment including consequential losses (business income, loss of rents, extra expense) caused by an insured's peril.

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