carve-out


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carve-out

(karv-owt),
That portion of a provider bill denied for payment (for example, by an insurer). The term may be modified by a time period (for example, day c.), for a Sunday when no diagnostic or specific therapeutic activities were undertaken for a hospitalized patient.

carve-out

a service not covered in a health insurance contract. It is usually reimbursed according to a different arrangement or rate formula than those services specified under the contract umbrella.

carve-out

adjective Referring or pertaining to:
(1) A program that excludes certain services—usually from an organisation’s capitated rate—and tends to focus on one disease in depth;
(2) An arrangement in which some benefits (e.g., mental health) are removed from coverage provided by an insurance plan, but are provided through a contract with a separate set of providers;
(3) A population subgroup for whom separate healthcare arrangements are made.

carve-out

Managed care adjective Referring to
1. A program that excludes certain services—usually from an organization's capitated rate—and tends to focus on one disease in depth.
2. An arrangement in which some benefits–eg mental health are removed from coverage provided by an insurance plan, but are provided through a contract with a separate set of providers.
3. A population subgroup for whom separate health care arrangements are made.

carve-out

(kahrv'owt)
Portion of a health care provider's charges denied for payment (e.g., by an insurer).
References in periodicals archive ?
That's a very bad precedent, and it's raising alarm among American producers worried that other countries will seek their own carve-outs.
The pricing process of ECOs during the registration period begins when the parent firm announces the decision to carve-out the subsidiary through a public offering.
The Adoption of Carve-Out Contracts and Their Hypothesized Impacts on the Utilization of New Medical Technology
As the Upjohn research makes clear, enthusiasm for the carve-out model rests on slim evidence.
The impact of a tracking stock on the financial statements of the company is relatively minor compared to a carve-out and spin-off (see Table 1).
A smaller group, including Thermo Electron, Enron, Genzyme, Safeguard Scientifics and, more recently, The Limited, have chosen the carve-out as their basic organizing structure, repeatedly selling stakes in their business units.
We track the parent companies' ownership stake of the carved out subsidiary for the four years following the carve-out and measure operating performance of the parent and subsidiary companies' assets for six years following the carve-out.
Carve-outs were sold to them, not just on the basis of cost containment, but also on the basis of quality-and businesses have been grievously disappointed, he added.
In contrast to the above studies, Slovin, Sushka, and Ferraro (1995), using a sample of 36 equity carve-outs over 1980-1991, find that share prices of equity carve-out rival firms react negatively to carve-out announcements.
Companies seeking to optimise their business face complexity in both IFRS and US GP accounting for mergers, acquisitions, initial public offerings and carve-outs.
Aterian's principals have extensive experience investing in complicated situations including corporate carve-outs, restructurings both in and out of bankruptcy, and strategic investments necessary to build and enhance value for all stakeholders.
The lender's ability to include in the loan documentation an extensive list of carve-outs or exceptions to the non-recourse provisions for certain enumerated events or egregious behaviours by the borrower is very much a function of market conditions and the negotiating strength of the parties.