carve-out

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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

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

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