- Certificate of Need (CON)
- A state regulatory approval required in some US states before opening a new healthcare facility or adding major medical equipment or services.
- Payer Mix
- The breakdown of a clinic's revenue sources by insurance type — Medicare, Medicaid, commercial insurance, and self-pay — expressed as a percentage of total revenue.
- Credentialing
- The process by which a healthcare facility verifies a clinician's education, training, licensure, and competency before granting them privileges to see patients.
- HIPAA
- The Health Insurance Portability and Accountability Act — US federal law that governs the privacy and security of patient health information.
- Fee Schedule
- A list of the maximum amounts a clinic will accept as payment for each service, typically set by reference to Medicare rates or commercial payer contracts.
- Revenue Cycle Management (RCM)
- The administrative and financial process covering patient registration, coding, billing, claims submission, and collections — from the first appointment to the final payment.
- Full Practice Authority (FPA)
- State-level authorization allowing nurse practitioners to evaluate, diagnose, and treat patients and prescribe medications independently, without physician supervision.
- FQHC (Federally Qualified Health Center)
- A community-based health care provider that receives federal funding under the Health Center Program and serves underserved populations on a sliding-fee scale.
- Overhead Ratio
- Total operating expenses divided by gross revenue — a key efficiency metric for medical practices, with a healthy target typically below 60%.
- Panel Size
- The number of active patients assigned to or seen by a single physician or care team, used to estimate capacity and staffing needs.