72-hour rule / 24-hour rule

Medicare policy that states if a patient receives diagnostic tests and hospital outpatient services within 72 hours of admission to a hospital, then all such tests and services are combined (bundled) with inpatient services only if services are related to the admission. However, unrelated therapeutic service is paid. Also called the 3-day payment window because it is 3 calendar days rather than 72 hours. Sometimes called the 72/24-hour rule.

8 ths Method

 

Based on the assumption that annual policies are written evenly over each quarter and that risk is spread out evenly over the year, this method is used to estimate the unearned premium reserve. Policies written in the first, second, third, and fourth quarters of each year, for example, are assumed to contribute one-eighth, three-eighths, five-eighths, and seven-eighths of the written premium to the unearned premium reserve at the end of the year, respectively.

A.M. Best rating

 

An evaluation published by A.M. Best Company of all life, property, and casualty insurers domiciled in the United States and U.S. branches of foreign property insurer groups active in the United States. The ratings are frequently used to assess insurance companies’ claims-paying ability, suitability, service record, and financial stability. Standard & Poor’s, Conning & Company, Fitch, and Moody’s are some of the other rating agencies.

A.T.

American Terms is a term used to differentiate between the conditions of American policies from those of other nations, principally England.

A/B jurisdictions

Fifteen regions in the United States assigned to Medicare Administrative Contractors (MACs) for receiving and processing insurance claims for Medicare Parts A and B.

Medicare Parts A/B Jurisdictions of Medicare Administrative Contractors (MACs) .

Jurisdiction 1: American Samoa, California, Guam, Hawaii, Nevada, and Northern Mariana Islands.

Jurisdiction 2: Alaska, Idaho, Oregon, and Washington.

Jurisdiction 3: Arizona, Montana, North Dakota, South Dakota, Utah, and Wyoming.

Jurisdiction 4: Colorado, New Mexico, Oklahoma, and Texas.

Jurisdiction 5: Iowa, Kansas, Missouri, and Nebraska.

Jurisdiction 6: Illinois, Minnesota, and Wisconsin.

Jurisdiction 7: Arkansas, Louisiana, and Mississippi.

Jurisdiction 8: Indiana and Michigan.

Jurisdiction 9: Florida, Puerto Rico, and U.S. Virgin Islands.

Jurisdiction 10: Alabama, Georgia, and Tennessee.

Jurisdiction 11: North Carolina, South Carolina, Virginia, and West Virginia.

Jurisdiction 12: Delaware, District of Columbia, Maryland, New Jersey, and Pennsylvania.

Jurisdiction 13: Connecticut and New York.

Jurisdiction 14: Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont.

Jurisdiction 15: Kentucky and Ohio.

A1

MARINE: This is the highest rating given by Lloyd’s Register to a ship for its seaworthiness. It is also known as “First Class.” The letter “A” indicates that the ship’s hull is strong and safe on the water, and the letter “1” indicates that its rigging and gear are in good condition.

USA MEDICAL: HCPCS Level II modifier for wound dressing that can be used with CPT or HCPCS Level II codes. The use of this modifier has an impact on Medicare payment.