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Glossary

  1. O

    Other Party Liability (OPL)
    A cost containment program that recovers money where primary responsibility does not exist because of another group health plan or contractual exclusions. Includes coordination of benefits, Workers' Compensation, subrogation and no-fault auto insurance.
    out-of-pocket maximums
    Dollar amounts set by MCOs that limit the amount a member has to pay out of his/her own pocket for particular healthcare services during a particular time period.
    outpatient care
    Treatment that is provided to a patient who is able to return home after care without an overnight stay in a hospital or other inpatient facility.