Utilization Review Organization (URO): External reviewers who assess the medical appropriateness of suggested courses of treatment for patients, thereby providing the patient and the purchaser increased assurance of the appropriateness, value, and quality of healthcare services.

 

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Utilization Review Organization (URO): External reviewers who assess the medical appropriateness of suggested courses of treatment for patients, thereby providing the patient and the purchaser increased assurance of the appropria . . . View Full Definition

Preferred Provider Organization (PPO) Plan: A specific type of CIGNA health plan with a national network of physicians. Plan members can visit physicians both in and out of the network, and can visit specialists without a referral. Me . . . View Full Definition

Preferred Provider Organization (PPO): A healthcare benefit arrangement designed to supply services at a discounted cost by providing incentives for members to use designated healthcare providers (who contract with the PPO at a d . . . View Full Definition

Pre-Admission Review: A review of an individual's health care status or condition, prior to an individual being admitted to an inpatient health care facility, such as a hospital. Pre-admission reviews are often c . . . View Full Definition

Preferred Provider Organizations (Ppos): You or your employer receive discounted rates if you use doctors from a pre-selected group. If you use a physician outside the PPO plan, you must pay more for the medical care.

Pre-Admission Certification-Continued Stay Review (PAC-CSR): The process through which the reviewer evaluates the attending physician's request for admission to an acute care hospital and length of stay. Medical necessity is determined using establish . . . View Full Definition

Private Voluntary Organization (PVO): A nongovernmental, nonprofit organization that provides economic and social assistance to people in need, often in foreign countries. Pvos play an important role, along with cooperatives, in . . . View Full Definition

Preview Pane: The window in an email client that allows the user to scan message content without actually clicking on the message. See open rate.

Professional Employer Organization (PEO): An organization that enters into a join-employment relationship with an employer, by leasing employees to the employer, allowing the PEO to share and manage many employer-related responsibil . . . View Full Definition

Physician-Hospital Organization (PHO): A joint venture between a hospital and many or all of its admitting physicians whose primary purpose is contract negotiations with MCOs and marketing.