Dictionary

The Dictionary provides concise definitions of health economics terms, arranged alphabetically for quick reference. Use it to understand unfamiliar terminology or confirm the meaning of a specific term.

8 terms matching Coverage Decision

A

Appeal Process Insurance
The formal procedure through which an insured individual can challenge a denied claim or coverage decision, requesting reconsideration.
Applied Benefit Assessment
A benefit assessment carried out within a specific reimbursement or coverage decision rather than as a general methodological exercise.

B

Benefit-Risk Assessment
A structured evaluation comparing a technology's expected clinical benefits against its potential harms, used to inform approval and coverage decisions.

C

Coverage Decision
The formal determination by a payer or assessment body regarding whether, and under what conditions, a technology will be reimbursed.

E

Essential Benefit Assessment
A benefit assessment restricted to the core evidence needed to support a coverage decision, without further supporting analysis.

I

IQWiG
The Institute for Quality and Efficiency in Health Care, Germany's body conducting evidence-based benefit assessments informing G-BA coverage decisions.

R

Regional HTA Agency
An assessment organisation operating at a subnational, regional level, informing coverage decisions specific to that region rather than a whole country.

S

Strategic Utilisation ReviewStrategic Utilization Review
A utilisation review oriented toward informing long-term health plan design rather than a single, immediate coverage decision.