An organization that contracts with insurers to provide loss settlement services on behalf of those insurers.
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Organization for adjusting insurance claims that is supported by insurers using the bureau’s services.
Insurance Encyclopedia
Adjustment codes
Special codes used by insurance carriers to explain the reason an insurance claim or a medical service was paid differently than the billed amount.
Adjustment income
A benefit that provides an income to a beneficiary once the primary wage earner has died. This income is intended to help cover expenses until the beneficiary is self sufficient.
Adjustment premium
An additional premium payable under the terms of the contract as a result of claims experienced under a policy of insurance or reinsurance.
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An additional or return premium that is payable in relation to a deposit premium depending on the performance of an insurance or reinsurance contract.
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The adjustment premium is a further premium payable at the end of a period of cover. This may result from the use of retrospective experience rating or from a situation where the exposure cannot be adequately determined at the start of the period of cover.
Adjustment provision
A stipulation in a policy that permits changes to the policy, which are then executed by increasing or decreasing the premium or face amount. Also can be changed by extending or decreasing the duration of protection or premiums.
Adjustment reasons
Reference list of coded explanations of changes made to a paid insurance claim. The codes detail and clarify all services reported and eliminate having to generate a separate letter of explanation.
Adjustments to payment rates
Changes or modifications to the base payment rates to allow for differences in providers’ situations that affect their costs of giving medical services. These adjustments are to accommodate differences in local prices for products and services, delivery of specialized types of care, or atypical characteristics of beneficiaries.
Adjuvant technique
Additional technique(s) that may be required at the time a bypass graft is created to improve patency of the lower extremity autogenous or synthetic bypass graft or fistula. Use of CPT codes 35685 and 35686 are add-on codes and should be reported with a code for the primary procedure performed.
Administration
Policies, procedures, and management of functions related to the operation of an insurance plan by the insurance company after it becomes effective. In some situations, the insurance claims processing and payment may be administered by a separate entity.
Administration Bond
Refer: “Bond, Administration Bond.”
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UK: A bond issued to the Principal Probate Registrar against defaults by the person (i.e. the administrator) appointed to administer the estate of another.