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 ?
Even though carve-out contracts in health care delivery have existed for some time in the United States, (11) it was during the same period as the introduction of these psychotropic drugs that significant transformations occurred in the delivery of mental health services and in the broader adoption of carve-out contracts.
As the Upjohn research makes clear, enthusiasm for the carve-out model rests on slim evidence.
2)Independent carve-outs >75% of shares for public trading; parent- controlled carve-out offer <75% of shares for public trading.
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).
While mental health carve-out organizations, which are often based within capitated insurance systems, may be more efficient and less costly in treating patients with mental health problems (Frank et al.
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.
A carve-out for waste should be limited to "material" waste to the Property and, to the extent possible, should be limited to "intentional" acts by a borrower or its principals.
The initial carve-out followed by a second divestiture event increases company focus when the combination carve-out reduces number of industries for the parent.
The tobacco carve-out is especially counterproductive because its economic importance is so small.
Our analysis confirms that both price update and initial return of carve-out IPOs can be predicted based on the parent firm's returns during the prepricing and preissuing periods.
size and industry) and not necessarily to status as a carve-out.
For more than 20 years, the Valley has managed to escape the area-code carve-outs that have hit much of the rest of metropolitan Southern California.