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• Accreditation
• Active life reserve
• Administrative-services-only contract
• Aggregate excess-loss coverage
• Arbitration

• Capitation
• Capitation arrangements
• Census data factors
• Centers of excellence
• Complaint
• Concurrent review
• Continuous quality improvement (CQI) or total quality management
• Coordination of Benefits (COB)
• Covered person (participant, eligible employee)
• Credentialing

• Defensive medicine
• Dual Option

• Employer accounting
• Effective case management
• Employment Retirement Income Security Act of 1974 (ERISA)
• EOB
• Exclusive provider organizations (EPOs)
• Experience stabilization reserve

• Federal Employee Health Benefits Program (FEHBP)
• Federal Health Maintenance Organization (HMO) Act of 1973
• Fiduciary (under ERISA)

• Individual (or independent) practices association (IPA)
• Intermediary
• IPA-model HMO

• Managed care
• Managed care organizations (MCOs)
• Medical savings account (MSA)
• Member satisfaction surveys

• Negotiated fee

• Outpatient pre-certification

• Peer review
• Plan accounting
• Point-of-service (POS)
• Pre-admission certification
• Preferred Provider Arrangement Model Act
• Preferred Provider Organization (PPO)

• Quality Assurance (QA)

• Referral authorization
• Retrospective rating

• Specific attachment point
• Specific excess-loss coverage
• Staff-Model HMO
• Subrogation

• Underwriting
• Utilization review