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  2. List of healthcare accreditation organizations in the United ...

    en.wikipedia.org/wiki/List_of_healthcare...

    Global Healthcare Accreditation (GHA) [5] Healthcare Facilities Accreditation Program (HFAP) Healthcare Quality Association on Accreditation (HQAA) Institute for Medical Quality (IMQ) Joint Commission (TJC) National Committee for Quality Assurance (NCQA) National Dialysis Accreditation Commission (NDAC) [6] The Compliance Team, "Exemplary ...

  3. Medical malpractice - Wikipedia

    en.wikipedia.org/wiki/Medical_malpractice

    In common law jurisdictions, medical malpractice liability is normally based on the tort of negligence. [3]Although the law of medical malpractice differs significantly between nations, as a broad general rule liability follows when a health care practitioner does not show a fair, reasonable and competent degree of skill when providing medical care to a patient. [3]

  4. Credentialing - Wikipedia

    en.wikipedia.org/wiki/Credentialing

    Credentialing is the process of granting a designation, such as a certificate or license, by assessing an individual's knowledge, skill, or performance level. In healthcare industry, credentialing is defined as a formal process that employs a set of guidelines to ensure that patients receive the best possible care from healthcare professionals ...

  5. Health care provider - Wikipedia

    en.wikipedia.org/wiki/Health_care_provider

    A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive payments for their services rendered from health insurance providers. In the United States, the ...

  6. Standard of care - Wikipedia

    en.wikipedia.org/wiki/Standard_of_care

    4. A recipient of pro bono (free) services (either legal or medical) is entitled to expect the same standard of care as a person who pays for the same services, to prevent an indigent person from being entitled to only substandard care. [2] Medical standards of care exist for many conditions, including diabetes, [3] some cancers, [4] and sexual ...

  7. Medical necessity - Wikipedia

    en.wikipedia.org/wiki/Medical_necessity

    Medical necessity is a legal doctrine in the United States related to activities that may be justified as reasonable, necessary, and/or appropriate based on evidence-based clinical standards of care. In contrast, unnecessary health care lacks such justification. Other countries may have medical doctrines or legal rules covering broadly similar ...

  8. Medical outsourcing - Wikipedia

    en.wikipedia.org/wiki/Medical_outsourcing

    People needing or wanting healthcare sometimes make decisions to seek care in a different jurisdiction; the decision may be based on lack of quality, availability, or legality in the person's home jurisdiction, or it may be a business decision based on the cost of acquiring the care. This form of medical outsourcing on the consumer side is ...

  9. Pharmacy benefit management - Wikipedia

    en.wikipedia.org/wiki/Pharmacy_benefit_management

    The Knox-Keene Health Care Service Plan Act of 1975 is a set of Californian laws that regulate Healthcare Service Plans. Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits