Alternate delivery system (ADS)

1. Any health care delivery system other than traditional fee-for-service (e.g., health maintenance organization [HMO], preferred provider organization [PPO], individual practice association [IPA]). 2. Provision of health services in settings that are more cost effective than an inpatient, acute-care hospital such as skilled and intermediate nursing facilities, hospice program, and in-home services.

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