Managed Care Organization (mco)
Definition of "Managed care organization (mco)"
Entity that offers a managed care plan for workers compensation benefits that joins a provider network with the following parts: case management personnel, medical bill review personnel, internal dispute resolution vehicle, written guidelines for treatment of cases, quality assurance program, and a utilization review committee. This mechanism executes in the following manner:
- Case management personnel monitors treatment of an injured employee to make sure the employee recovers from illness and returns to work in a timely fashion.
- Guidelines for treatment of cases written criteria for determining when an illness requires medical treatment, scope of the medical treatment, and acceptable disability time periods.
- Internal dispute resolution vehicle provides written instructions for procedures to resolve conflicts in issues between health providers and fee payers regarding the size of medical fees charged, type and scope of medical treatment, and over utilization of medical facilities.
- Utilization review committee provides guidelines for inpatient hospital care, outpatient care, and physician care.
Popular Insurance Terms
Same as term Disability Benefit: income paid under a disability policy that is not covered under workers compensation benefits. It is usually expressed as a percentage of the insured's ...
To which the original investment sums build at a stipulated interest rate. ...
Ordinary life insurance under which premiums are calculated so that the first few years of premiums are less than normal, and subsequent premiums are higher than normal. ...
Endorsement to a homeowners insurance policy or a personal automobile policy (pap) that covers physical damage to a snowmobile wherever it happens to be. Coverage can be on named peril or ...
Specific time at which the insurance policy coverage begins and ends. ...
Individual licensed to sell securities to the public. For example, to sell variable annuities and variable life insurance products and mutual funds, an insurance agent is required to pass ...
Insurance on the life of the employee, paid for by the company, with the company being the beneficiary under the policy. This insurance vehicle is being used more and more to fund ...
Coverage in which an applicant lot required to take a medical examination, instead answers written questions to ascertain his current physical condition. ...
Provision in many property insurance policies that allows an insured to pick coverage for selected perils. The choices are explosion; explosion, riot and civil commotion; explosion, riot ...
Have a question or comment?
We're here to help.