Handmade is a much abused term in jewellery.  It should mean that the design has been built up by cutting sheet or wire silver, shaping it, soldering it, filing it  until eventually the design is complete. In practice it is often used to describe jewellery that has been cast from a mould, and merely hand finished, which means a small amount of filing and polishing (by machine).  There is not much truly hand made jewellery currently made in the UK, but Byezantium does still offer genuine handmade jewellery, usually to order.  It has the advantage that, as the settings are made individually, any size or shape of stone can be used, and a truly unique design produced. 

The amount of work involved usually means it will be more expensive than cast jewellery, rather like original paintings  being more valuable than prints.