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Delaware Healthcare Association Glossary of Health Care Terms and Acronyms - Terms Starting with B

If you would like to recommend additions to the Delaware Healthcare Association's Glossary, send them for consideration to Yasmine Chinoy at yasmine@deha.org.

 

DISCLAIMER

The definitions listed here are intended for a general understanding of a health care term. These definitions should not be considered as the complete definition, since many are written in the simplest form to give a general understanding of the term listed.

 

Terms Starting with B:

 
 

Bachelors of Science in Nursing (BSN)

Degree received after completing a four-year college or university program that qualifies a graduate nurse to take a national licensing exam to become a registered nurse.

Balance Bill

The fee amount remaining after patient co-payments.

Balance Billing

A provider's billing of a covered person directly for charges above the amount reimbursed by the health plan (i.e., difference between billed charges and the amount paid).  This may or may not be allowed, depending upon the contractual arrangements between the parties.

Balanced Budget Act of 1997

This law made sweeping changes in the Medicare and Medicaid programs.  Several of the significant provisions of the BBA were payment reductions to health care providers, new prospective payment systems for health care providers, and reduction of coverage of health care services by the Medicare and Medicaid programs.

Base

A set dollar amount to cover the cost of health care per covered person excluding mental health/substance abuse services, pharmacy and administrative charges.

Base Capitation

A stipulated dollar amount to cover the health care per covered person less mental health/substance abuse services, pharmacy and administrative charges.

Basic Benefits Package

A core set of health benefits that everyone in the country should have either through their employer, a government program, or a risk pool.

Bed Days/1000

The number of impatient days per 1,000 health plan members for a fixed period of time.

Bed Reservation Benefit

In some long-term care policies, a benefit paid to maintain the enrollee's space in a nursing home facility when the enrollee must be hospitalized temporarily.

Behavioral Health Care

Mental services, including services for alcohol and substance abuse.

Benchmarks

Long-range measurable goals that speak to changing conditions.  See also Performance Measures, Quality Assurance, Key Indicators, Outcomes.

Beneficiary

A person designated by an insuring organization as eligible to receive insurance benefits.

Benefit

Amount payable by the insurance company to a claimant, assignee, or beneficiary, when the insured suffers a loss covered by the policy.

Benefit Amount

See benefit level.

Benefit Cap

The lifetime dollar or day limitation of an insurance policy.

Benefit Design

Selection of services, providers, and beneficiary obligations to create the scope of coverage.

Benefit Level

The limit or degree of services a person is entitled to receive based on his/her contract with a health plan or insurer.

Benefit Limit

Benefit Maximum

Benefit Package

Services an insurer, government agency, health plan, or an employer offers under the terms of a contract.

Benefit Payment Schedule

List of the amounts an insurance plan will pay for covered health care services.

Benefit Period

The maximum length of time specified in an insurance product during which benefits will be paid.

Benefit Redesign

Restructuring employee health benefit plans by providing incentives for prudent consumer behavior, such as introducing coverage for treatment in alternative settings; establishing managed care provisions such as pre-admission testing, second surgical opinions and pre-admission certification; establishing alternative financial arrangements, such as creating individual health accounts; or changing employee premium contribution, co-payment, or deductible levels.

Benefits Tax

A tax all workers would be required to pay based on the value of employer-provided health benefits which exceeds a certain level, or a limit on the tax deduction employers currently take for providing benefits.

Biased Selection

The phenomena whereby individuals or groups with atypical health risks disproportionately enroll in a specific health plan or type of health plan.  Favorable selection occurs when a plan's enrollment predominantly consists of above-average health risks, while plans that disproportionately enroll individuals (and groups) of below-average health risks are said to experience adverse selection.  Biased selection may be influenced by individual decisions in response to benefit design and plan characteristics as well as by insurer marketing and rating practices.

Billed Claims

The fees or costs for health care services provided to a covered person submitted by a health care provider.

Biomedical Engineering Technician

Inspects, repairs, maintains, calibrates and modifies electronic, electrical, mechanical, and hydraulic equipment and instruments used in medical therapy and diagnosis, according to schematic and verbal instructions

Block Grant

An intergovernmental transfer of Federal funds to states and local governments for broad purposes such as health, education or community development in general.  A block grant holds few requirements for how the money is to be spent, instead offering state and local discretion within general guidelines established by Congress and the executive branch.  Annual program plans or applications are normally required.  Also see categorical grant or formula grant.

Blue Cross and Blue Shield Association (BC/BS)

An organization that offers information, consultation, representation and operational services for the Blue Cross and Blue Shield plan members across the country for purposes of providing insurance benefits.

Board and Care

Residential option providing no direct health or personal care services.  Also see foster care, rest residential care, family rest residential care, and adult foster care.

Board Certified

A clinician who has passed the national examination in a particular field.  Board certification is available for most physician specialties, as well as for many allied medical professions.

Board Eligible

A term used to describe a physician who is eligible to take the specialty board examination by virtue of having graduated from an approved medical school, completed a specific type and length of training and practiced for a specified amount of time.

Botique Hospital

A limited service hospital designed to provide one medical specialty such as orthopedic or cardiac care.

Bundled Payment

The use of a single payment for a group of related services.

Bundled Rate

Payments that represent an amalgamation of services.

Bundled Services

A single comprehensive group of related services.  Payments for bundled services have become the norm in recent years and unbundled services are investigated closely by the Centers for Medicare and Medicaid Services (CMS) and other payers for evidence of fraud.

Bundling Payment

The same as Bundled Payment.  The use of a single payment for a group of related services.

Buy-In

Refers to instances where a state Medicaid program agrees to pay the Medicare premiums and cost sharing for members of a specified group.

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Dover, DE 19904
302.674.2853