Clip and Copy: Translating insurance-speak for patients

This handout will help them distinguish a PPO from a POS.

Whatever else it's done, managed care has spawned a bewildering array of new terms: capitation, closed model HMO, formulary, point of service, preferred provider organization, self-insured plan—no wonder patients are so confused.

To help you help them better understand the language of managed care—and what it means to your relationship with them—we've put together the patient handout below. It explains terms they come across regularly—but may never have fully understood. Access to clear, concise definitions will not only make your doctor-patient encounters easier; it will also help patients in their general dealings with their health plan.

The handout also instructs patients to consult with you—their doctor—if they require added clarification about a specific topic.

This handout is your chance to speak directly to patients about a matter of common concern, to let them know what the terms their insurer tosses out actually mean to you. We encourage you to photocopy the form (we've left room at the bottom for you to stamp your name). You can also have it commercially copied and customized.

—Senior Editor
Wayne J. Guglielmo

To view the form in Word you must have Word 2000 or better. If you don't have this program you can download the free Microsoft Word 97/2000 Viewer. (You cannot edit an open document in Word Viewer. However, you can copy text to the Clipboard to paste it in other applications).

Other forms and patient handouts are available in the Clip and Copy section of our Web site at www.memag.com .

Wayne Guglielmo. Clip and Copy: Translating insurance-speak for patients. Medical Economics Dec. 19, 2003;80:70.