Stopless [Stoploss stop-loss stop loss] Threshold

Discussion in 'English Only' started by maaaar, Jul 26, 2008.

  1. maaaar Senior Member


    Can somebody tell me what is in a hospital a stopless threshold. I found it in the following context:

    "UTI, Cardiac Sv., Surgical, Psychiatric, Stopless threshold."

    Thanks a lot!!
    : health care
  2. languageGuy Senior Member

    Kansas City, MO
    USA and English
    Could this be a typo? Perhaps it should be a "stop-loss threshold".
  3. maaaar Senior Member

    In case you are right, could you tell me what could it be its deffinition?

    Thanks again!
  4. fsabroso

    fsabroso Moderadiólogo

    South Texas
    Perú / Castellano
    I answered this in Medical forum; but I'm not sure if I understand this correctly.
    In this context, could the "threshold" refers to the "services" given in any given facility?
  5. Waylink Senior Member

    English (British)
  6. gasman Senior Member

    Canada, English
    It would appear to be a term used in the US.
  7. maaaar Senior Member

    Thanks to all, but could you give me a word or a sentence where I could put this together? Like the other institutions, stop loss threshold must be a place in a hospital like a ITU, or an Obstetrics...

    Yes, I think it is a term used in US, but it corresponds to... in an hospital.

    Thanks to all again.
  8. Nunty

    Nunty Modified

    Hebrew-US English (bilingual)
    Stop loss threshold appears to be an American term that has to do with reimbursement for hospital services under their "managed care" system. It's been too long since I worked in the US, so I don't know any more than that, but if you're intrepid, here is a link to the Google hits.

    If the term appears, as fsabroso suggests, in a list under a "Find a facility" rubric, then it looks like the stop loss threshold of a hospital can be used as a keyword for searches on that site. (This is on an Internet a site, right? "Find a facility" seems to imply that.) In other words, people could search for a hosptial with any of the specific clinical departments listed and/or one that uses this stop loss technique.

    If this isn't for a site but for a sign with directions in the hospital itself, then maybe it refers to the part of the billing office that deals with matters related to its stop loss threshold.

    (Please notice my use of "suggests", "looks like" and "seems". These are just educated guesses.)
  9. panjandrum

    panjandrum PongoMod

    Belfast, Ireland
    English-Ireland (top end)
  10. maaaar Senior Member

    Thanks to all. It appears that languageGay is right, there is a typo and it is Stop loss threshold. Then, after all your valuable help, I am thinking that it means the recovery room after a surgery.

    what do you think?
  11. panjandrum

    panjandrum PongoMod

    Belfast, Ireland
    English-Ireland (top end)
    That is not the impression I get from the comments above.

    Please, maaar, tell us where you found this list of words.
    Give us context.
  12. Nunty

    Nunty Modified

    Hebrew-US English (bilingual)
    Maaaar, why do you think it means the recovery room? That doesn't make too much sense to this ex-nurse.
  13. gasman Senior Member

    Canada, English
    "recovery room" makes absolutely no sense in this context. There is no connection between the phrase and reality in hospital clinical units.
  14. maaaar Senior Member

    Hello Gasman,

    First of all, thank you for your interest. This words are contained in a diagram of the brochure for a health insurance plan in the company´s internet page.

    Here is the context:

    Customer Center - Find a Provider
    Facility Results:
    Click on the dollar sign to see the amount your plan pays per day for each bed type. Not all facilities perform all services. We encourage members to contact the facilities to discuss the services available. Click on the facility name for more information.

    Bed Type: Medical, Surgical, Cardiac Svcs, ICU, Neonatal ICU, OB Normal Delivery, OB C Section, Psychiatric, Substance Abuse, Stoploss Threshold.
    (After that, "Cost to you: low----$---high" for each of the above.

    Then there are some names and addresses of hospitals.

    What do you think? I coud give you a piece of text before that but y do not find any connection....

    Thanks a lot!:)
  15. Loob

    Loob Senior Member

    English UK
    It appears from the context to mean, not a physical place in a hospital, but a bed-space covered by a particular type of insurance arrangement.

    But that's as far as this Brit can go:)
  16. Nunty

    Nunty Modified

    Hebrew-US English (bilingual)
    I was a head nurse in the US before managed care but during the Medicaid era. It seems clear to me that the "stoploss threshold" refers to a "type of bed". Not all hospitals have stoploss reimbursement in place, and this looks like a way to find one that does.

    In any event, the initial phrase "for each bed type" makes it clear to me that "stoploss threshold" is a bed type for the purposes of this brochure.
  17. panjandrum

    panjandrum PongoMod

    Belfast, Ireland
    English-Ireland (top end)
    Stop loss threshold is a health insurance term.
    The insurance company reimburses at an agreed rate.
    If the total charges exceed the stop loss threshold, a new reimbursement regime comes into play.
    The new regime is less favourable to the insured person, of course.

    I suppose it is possible that a health facility may have special beds for patients whose charges have exceeded the stop loss threshold.

    (Caution: This is based on investigation by a non-US ape who incidentally knows about health-care administration. It may be completely wrong.)
    Last edited: Jul 26, 2008
  18. maaaar Senior Member

    Thanks a lot panjandrum :=)
  19. maaaar Senior Member

    Thank you Nun Translator and thank you Loob!:=)
  20. fsabroso

    fsabroso Moderadiólogo

    South Texas
    Perú / Castellano
    Well, it looks like "stop loss" is definitely not a medical term but financial, used in health care insurance policies:

    I found these:
  21. maaaar Senior Member

    I thank you Nun Translator. I think that´s it! Thanks to all!
  22. Nunty

    Nunty Modified

    Hebrew-US English (bilingual)
    By the way, the confusion might have to do with the phrase "bed type". In a hospital "bed" does not just mean the actually piece of furniture someone sleeps on and that is located in a ward. It is also be used as an abstraction to refer to a type of care, a type of billing, a type of accomodation.
  23. maaaar Senior Member

    Yes, Nun Translator, I am aware of that, thank you very much.
  24. Ins Exec New Member

    Three ways the term stop loss can apply:
    1. Within a medical insurance plan, the member can be protected from large losses by having a "stop loss" or maximum out of pocket dollar figure per policy period.
    2. For a self-funded medical plan sponsor (usually an employer), stop loss is insurance purchased to protect the plan sponsor against large losses. Individual stop loss (also known as specific stop loss) says that the plan sponsor's liability for any one member's claims during the policy period (usually 12 month) will end at $X. After $X, the claims for that member for the remainder of the policy period, will be paid by the stop loss insurance carrier. $X is usually $50,000 to $300,000, depending on the size of the plan sponsor's group. For aggregate stop loss, the stop loss insurance carrier will pay any claims that exceed X% over an overall annual maximum amount, set before the policy year starts as "projected annual claims." The plan sponsor accepts the projected annual claims liability PLUS 10% or 20% or 25% above this. Once the aggregate limit has been reached, then the stop loss carrier begins to pay. As would be expected, individual stop loss is more expensive than aggregate and individual stop loss keeps the aggregate maximum from being reached in the majority of cases.
    3. Hospital Stop Loss is a mechanism whereby hospitals who have entered into payment arrangements with insurance carriers (discounts, case rates, per diems) protect themselves against very large unusual claims being captured in too low of a rate. For example, a hospital has agreed to give an insurance carrier a rate of $2,500 per maternity case, even if that maternity case is inpatient for one night or 5 nights. However, the hospital also has a stop loss arrangement with a threshold of $100,000. A very complicated maternity case ends up multiple days in the hospital with multiple tests, procedures, etc. Once the actual charges exceed the $100,000, then the hospital is released from its "per case" agreement and begins to receive a percent of charges for the rest of the bill. Sometimes, the more generous reimbursement is applied to the high cost case for the entire bill, once the threshold is reached. It is as if the hospital is saying: we didn't intend for this type of unusual case to be part of the flat rate per maternity agreement.

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