GLOSSARY OF
HEALTH INSURANCE TERMS

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GLOSSARY OF HEALTH INSURANCE TERMS

N

National Committee on Quality Assurance (NCQA) — an independent, private sector group that reviews care quality and other procedures of managed care organizations to render an accreditation.

Neonatal Intensive Care Unit (NICU) — a unit of a hospital, especially designed and staffed to care for critically ill newborns.

Neonatologist — a physician who specializes in the treatment and diagnosis of newborns (up to 28 days of life).

Network — an affiliation of providers through formal and informal contracts and agreements. Networks may contract externally to obtain administrative and financial services. A list of physicians, hospitals and other providers who provide health care services to the beneficiaries of a specific managed care organization. See also IDS, PPO, PHO or Hospital Alliances.

Neurologist — a physician who specializes in diseases of the nervous system (e.g. multiple sclerosis, stroke).

Neurosurgeon — a physician who specializes in surgery of the nervous structures; brain and spinal cord.

Non-Formulary Drugs — drugs not on a plan-approved drug list.

Nonparticipating Physician (or Provider) — a provider, doctor or hospital that does not sign a contract to participate in a health plan, usually which requires reduced rates from the provider.

Non-Plan Provider — a health care provider without a contract with an insurer. Same as nonparticipating Provider.

Nosocomial Infections — infections that are acquired while a patient is in a hospital are referred to as nosocomial infections; a term derived from 'nosos,' the Greek word for 'disease.' Often nosocomial infections become apparent while the patient is still in the hospital but in some cases symptoms may not show up until after the affected patient is discharged. About one patient in 10 acquires an infection as a direct result of being hospitalized.

Nurse Practitioner (NP) — A registered nurse qualified and specially trained to provide primary care, including primary health care in homes and in ambulatory care facilities, long-term care facilities, and other health care institutions.