See: alternative funding mechanism.
Insurance Encyclopedia
Alternate treatment plan
Strategy for treatment of a patient other than in a hospital.
Alternate valuation date
For tax purposes, the value of a decedent’s estate is made as of the date of death. However, the estate executor may elect to value all estate assets 6 months from the date of death, the alternate valuation date.
Alternative basis clause
A business interruption policy clause to provide the insured with an alternative basis for adjusting a claim when the interruption is short and the turnover method impractical. The practice is for the insurer and the loss adjuster to calculate the loss on a ‘sales value of output’ basis, provided that the lost output cannot be regained within the indemnity period. Insurers are sufficiently flexible in their approach to allow this practice to be adopted even if the clause is not included.
Alternative billing codes (ABCs)
System of coding for integrative health care that consists of five-character alphabetic symbols with appended two-character practitioner modifiers that represent the practitioner type. These codes represent more than 4000 integrative health care products and services (Box A-2 ). ABC codes include the following specialty areas: acupuncturist, body work, chiropractic, conventional nursing, indigenous medicine, mental health care, minority health care, oriental medicine, physical medicine, spiritual and prayer-based healing, Ayurvedic medicine, botanical medicine, clinical nutrition, holistic dentists and physicians, homeopathy, massage therapy, midwifery, naturopathic medicine, osteopathic medicine, and somatic educational. ABCs were used to bill for these services as a pilot study maintained by Alternative Link, Inc. As of October 16, 2006, Alternative Link discontinued its pilot study. Covered entities under HIPAA may not use the codes in HIPAA transactions but may use the codes for non-HIPAA transactions. Also called advanced billing concept (ABC) codes. See also integrative health care and alternative medicine. Website: www.alternativelink.comBox A-2ABC CODE WITH MODIFIERThe following description illustrates the coding hierarchy of ABC code with modifier:CEBAM-1G High-risk pregnancy identification, Antepartum, Midwifery, Practice specialties
Alternative care
1. Nontraditional medical care given by providers such as acupuncturists. 2. Medical care received instead of inpatient hospitalization (e.g., outpatient surgery, home health care, skilled nursing facility care).
Alternative care facility (ACF)
Assisted living facility for elderly who do not need nursing care. ACFs have private and semiprivate rooms for residents and are usually near shopping and entertainment resources.
Alternative delivery system (ADS)
Phrase that indicates any other health care system other than the traditional fee-for-service or indemnity insurance.
Alternative dispute resolution (ADR)
Method or procedure used to settle insurance claims other than through a lawsuit. See also arbitration.
****
UK: A generic term meaning all methods of dispute resolution other than the court. ADR embraces: arbitration, adjudication, conciliation, early neutral evaluation, expert determination, executive tribunal (or mini-trial) or mediation. ADR is actively encouraged as a part of the pre-action protocols in the Civil Procedure Rules.
***
Methods other than lawsuits that are designed to resolve legal disputes. Examples are arbitration and mediation.
Alternative dispute resolution (Health Insurance)
Alternatives to the fee for service model, for example PPOs or HMOs. See entries PPO and HMO.