Evaluation conducted by a hospital or managed care plan to determine if the current place of service is the most appropriate to give the level of care needed by the patient. Also called utilization review (UR), utilization and management control, and medical review (UR).
Insurance Encyclopedia
Continuing care retirement communities (Health Insurance)
Communities where residents have easy access to health care.
continuing care retirement community (CCRC)
Self-sufficient community that provides residential services (meals, housekeeping, laundry) and housing to meet the needs of elderly individuals. There is usually a large lump-sum entrance fee and a monthly fee. CCRCs provide independent living, intermediate and skilled nursing care, personal care, and organized social and recreational activities designed for participation in community life. Licensed as nursing homes/residential care facilities or as homes for the aging.
Continuing claim
Insurance claim submitted for the same confinement or course of ongoing treatment for which a previous initial bill has been submitted. Such claims can be submitted every 30 or 60 days.
Continuing Duty of Utmost Good Faith
The revival or continuation of the precontractual duty of utmost good faith. The duty may be revived by policy conditions in regard to defined changes in risk or situations calling for fresh information as when cover applies under ‘held covered’ clauses. Where the change goes to the root of the contract, the insurer may come off risk, so the duty revives if the insurer is to continue the policy with a newly defined risk. The duty revives at the renewal of a contract. In addition good faith, meaning an absence of fraud, applies in the matter of claims.
continuing education (CE)
Formal education pursued by a working professional and intended to improve or maintain professional competence by obtaining current knowledge pertinent to the individual’s specific health care career. Also called continuing medical education.
Continuing education requirement
A required minimum amount of insurance-related education that license holders must complete to renew their licenses. Enforced by the state.
continuing medical education (CME)
See: continuing education (CE).
Continuing warranty
A warranty whereby the insured promises that a state of affairs will exist for the duration of the policy, e.g. disposing of waste at the end of each day. The policy is voidable from the date of the breach unless the court interprets the insurer’s words as being insufficient to amount to a continuing warranty, preferring to classify the words as a description of risk clause.
Continuity
Refers to a continuation of certain representations and warranties given by the insureds in the insurance application submitted to a prior insurer. When insureds first purchase a type of claims-made insurance from an insurer, the insurance company frequently requires the insureds to disclose all known facts or circumstances that may reasonably give rise to a future claim. Under some circumstances, the insurance company may agree not to require that disclosure from the insureds, but instead rely upon the disclosure by the insureds to the insurance company that previously issued a similar type insurance policy to the insureds. Continuity merely refers to a continuation of these representations and warranties from one insurer to the other, and does not mean there is a continuation of the same scope of coverage as was afforded under the prior insurance policy.