Glossary

Healthcare AI glossary

Plain-language definitions of the terms behind patient outreach: HEDIS, Star Ratings, SOA, PDC, MTM, AWV, BAA, TCPA, clinical trial recruitment, patient support programs, adverse-event intake, and more.

• AI receptionistAn AI receptionist answers calls, books appointments, and routes questions automatically, 24/7. Here is what it is, how it works, and what it means for a medical office.
• AI voice agentAn AI voice agent holds real phone conversations: it answers or places calls, understands speech, and takes action. Here is what it is and how healthcare uses it.
• HIPAA-compliant AIHIPAA-compliant AI can legally process protected health information, which requires a signed BAA and HIPAA-eligible infrastructure. Here is what actually makes AI HIPAA-compliant.
• AI medical answering serviceAn AI medical answering service answers patient calls 24/7 and resolves them, booking, routing, and answering, instead of just taking messages. Here is how it works.
• Business Associate Agreement (BAA)A BAA is the HIPAA contract that lets a vendor handle protected health information. Here is what it is, why AI tools need one, and how to get one included for free.
• Patient engagement automationPatient engagement automation uses software to run patient outreach and communication, reminders, recalls, refills, intake, at scale. Here is what it is and how it works.
• Scope of Appointment (SOA)A Scope of Appointment (SOA) is the CMS-required agreement a Medicare beneficiary signs before a sales meeting, documenting which plan types will be discussed. Here is how it works.
• HEDISHEDIS is the standardized set of quality measures most US health plans report, covering screenings, chronic-disease control, and preventive care. Here is what it is and why gap closure matters.
• Medicare Star RatingsMedicare Star Ratings score Medicare Advantage and Part D plans from 1 to 5 stars on quality and member experience. Here is what they measure and why they drive bonus payments.
• Medicare Shared Savings Program (MSSP)The Medicare Shared Savings Program (MSSP) lets Accountable Care Organizations share in savings when they lower the cost of care for their attributed Medicare patients while hitting quality targets.
• ACO REACHACO REACH is a CMS accountable-care model focused on health equity and coordinated care for traditional Medicare patients, with capitated payment and downside risk. Here is how it works.
• Proportion of Days Covered (PDC)PDC (Proportion of Days Covered) is the standard measure of medication adherence: the share of days a patient has their medication on hand. Here is how it works and why it drives Star Ratings.
• Medication Therapy Management (MTM)Medication Therapy Management (MTM) is a pharmacist-led service that reviews a patient's full medication list to improve safety, adherence, and outcomes. Here is what it is and who qualifies.
• Annual Wellness Visit (AWV)The Annual Wellness Visit (AWV) is a yearly Medicare benefit for prevention planning, not a physical exam. Here is what it covers, who qualifies, and why practices prioritize booking it.
• TCPA (Telephone Consumer Protection Act)The TCPA is the federal law governing automated calls and texts, including patient outreach. Here is what it requires, how healthcare messages fit, and why opt-out handling is essential.
• Clinical trial recruitmentClinical trial recruitment is the work of finding, reaching, and enrolling eligible participants. Here is why most adults with cancer never hear about a trial they qualify for, and what engagement changes.
• Patient support program (PSP)A patient support program helps referred patients start and stay on therapy. Here is what hub services do, where enrollment dies, and how first-contact outreach closes the loop.
• Adverse-event intakeAdverse-event intake is how a safety signal on a call, text, or chat is detected, transcribed, and routed inside the reporting window. Here is what that means for hubs and trials.