gatekeeper

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Gatekeeper

In insurance, requirements that a policyholder must fulfill before becoming eligible for a benefit. This especially applies to eligibility for long-term care in health insurance.

gatekeeper

a person who controls important information flows and access to other persons within an organization. The person concerned may have control over the information which goes up or down the organizational structure or in and out of the organization.

gatekeeper

A slang expression to describe the person you must persuade or impress just to get your proposal in front of a decision maker.

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References in periodicals archive ?
Patient care coordinators: Successfully merging utilization management & discharge planning.
Care coordinators go keep track of assigned patients in real time.--Executive Director, High-Performing Site ACO-D In contrast, the low-performing ACOs did not use EMRs effectively for care coordination; in fact, two did not have EMRs.
seems unable to articulate his situation adequately enough for the care coordinator to understand what is needed.
Conference Focus: The critical role of embedded care coordinators in population risk management as well as results achieved, including the following:
The integrated team will include a primary care provider, psychiatrist, behavioral health specialist, patient care coordinator, peer support specialists, community health RNs, certified alcohol and drug counselor, among others.
I hired a care coordinator at the assistance of Dr.
The program was somewhat unique because the physician manager and care coordinators had almost a direct line to home care services, to a doctor or pharmacist if they needed help, and they could get clinic appointments rapidly.
Recovery care coordinators (RCCs) help guide eligible service members along their road to recovery, whether they transition back to full duty or civilian life.
After data entry, the RN care coordinator screens all new patient referral documents (studies or films radiographic reports and clinic notes) to identify red flags that might warrant the need to bypass the spine specialist review.
In an analysis of the first year of the program, researchers at the University of Pittsburgh found that children who received intensive support from a care coordinator had fewer emergency department visits, fewer unplanned inpatient admissions, and lower costs for durable medical equipment.
NZNO's negotiating team was NZNO organisers Mark Lennox (Auckland) and Mike Yeats (Dunedin), RN and palliative care co-ordinator at Palmerston North's Arohanui Hospice, Stephanie Ash, health care assistant at Hospice Wanganui, Roberta Jones, enrolled nurse and quality improvement and education coordinator at Hospice Southland, Kirsty Robertson, and RN and palliative care coordinator at Hawke's Bay's Cranford Hospice, Faith Tough.
The care coordinator added her name to the list of patients for discussion at the pediatrician's weekly case conference meetings.