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goals and needs. Case management is most often used to deal with catastrophic illnesses. The case management coordinator helps to oversee overall management of the patient, from the onset of the illness or injury into acute care hospitalization, specialized care programs and follow-up treatment. Outpatient: A person who visits a clinic, emergency room or health facility and receives health care without being admitted as an overnight patient. Outpatient Surqery: Same day surgery without anticipation of the overnight stay of patients. This is often performed at an ambulatory care facility. Outpatient Surqical Facility: A freestanding center or entity within the hospital that is approved and licensed by the state to perform outpatient diagnostic services or surgical treatment of an illness or injury. Point of Service Plan (POS): Members do not have to choose how to receive services until services are needed. In some plans, for example, members decide whether to use a network provider or an outside provider. Although the services of an outside provider are covered, benefits are greater if members select a preferred provider (example 70% vs. 100% coverage). Preferred Provider Orqanization (PPO): A group of hospitals and physicians that contract on a fee-for- service basis with employers, insurance companies or other third party administrators to provide comprehensive medical service. Providers exchange discounted services for increased volume. Participants' out-of-pocket costs are usually lower than under a fee-for-service plan. Preventive Care: Comprehensive care emphasizing priorities for prevention, early detection and early treatment of conditions, generally including routine physical examinations, immunization and well person care. Primary Care: Routine medical care, normally provided in a doctor's office. Professional and related services administered by an internist, family practitioner, general practitioner, or pediatrician. Specialist: Physician who concentrates on medical activities in a particular specialty of medicine. Stop-Loss Provision: A stop-loss provision is determined in two ways: either after a certain amount of benefits is paid from the plan or after a certain amount of out-of-pocket expenses is paid by the individual or family unit. When the dollar amount specified is reached, the coinsurance factor is raised to 100%. When there is a stop-loss provision in the plan (besides the separate maximums and coinsurance levels on outpatient mental and nervous disorders), outpatient mental and nervous charges usually do not apply toward the dollar figures used to calculate when the stop-loss begins; after the stop-loss does begin, it does not apply to these charges. 17