Absolute net retention

After deducting all reinsurance recoveries, the amount of a loss that the reinsured retains net for its own account. A reinsurer may compel the reinsured to keep a minimum amount so that subsequent reinsurance purchases do not leave the reinsured with a purely nominal interest.

Absorb

Taking in and incorporating costs to claims, absorbing premium loading to the basic rate and thus quoting the net amount arrived at rate, and so on.

Abstract

1. To select information from a patient’s medical record using hard copy or electronic equipment for statistical purposes or to submit an insurance claim for reimbursement.

2. At the end of a patient’s hospital stay, the attending physician prepares a report that summarises the diagnosis, treatment, and results and outlines any further treatment after discharge. This is referred to as a discharge summary.

See Also: Case Summary Card.

Abstractor

Individual who electronically or manually selects and extracts information from a patient’s medical record from computer files or paper files. Coded diagnoses can be used in a facility to track morbidity and mortality, infectious disease, and index disease information for quality of care and utilisation review. Another use for extracted data is the submission of insurance claims.

Abuse

Under the Medicare programme, incidents or practises that are not usually considered fraudulent but are inconsistent with accepted sound medical business or fiscal practises (e.g., billing for noncovered services, excessive charges, improper billing practises, billing Medicare beneficiaries at a higher rate than other patients, submitting bills to Medicare instead of to primary third-party payers, billing for medically unnecessary services, violating the Medicare particpation agreement, billing for medically unnecessary services, violating the Medicare particpation agreement and billing for medically unnecessary services.