AM

HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating services performed by a physician associated with a team. Use of this modifier affects Medicare payment.

Amartya Shiksha Yojana Policy (Policy covering Education Expenses)

This policy is intended to pay for the insured student’s educational costs in the event that the providing parent or guardian is killed in an accident or becomes completely disabled for the rest of his life.

(a) The primary purpose of the policy is to pay for the covered student’s educational costs.

(b) The amount insured is determined by the cost of education for a certain course.

(c) The policy period (typically a long-term policy) corresponds to the duration of the course.

(d) A financial institution receives the compensation amount and releases funds in accordance with the needs of the educational institution.

(e) The insured student receives payment for the balance in the account at the end of the course.

(f) If a student stops studying, the money that is still in his account is reimbursed to him after the deadline, which is when the course would have completed if he had kept going.

One of the policy’s unique features is that it covers accidents where the parent or guardian dies as a result of surgery or within seven days of the procedure.

Ambiguity

When the Policy contains recital recourse may be had to them in constructing an ambiguity clause in the Policy, but where the operative words are unambiguous, the recital cannot be resorted to, vary their grammatical meaning. The assured cannot put his own meaning upon a Policy but, where it is ambiguous, it is to be constructed in the sense in which he might reasonably have understood it, if the Insurers wish to escape liability under given circumstances they must use words admitting of no possible doubts.

***

UK: See: Contra Proferentem Rule.

***

A standard policy provision that proves to be ambiguous may be interpreted in the light most favorable to the insured.

 

 

 

Ambulance fee schedule

In the Medicare program, a fee schedule for the payment of ambulance services that became effective April 1, 2002. This involves a 5-year transition during which payment is based on a blended amount—part fee schedule and part provider or supplier’s reasonable cost.

Ambulatory

1. A patient capable of moving without assistance. Also see activities of daily living (ADLs). 2. Descriptive term used when services are provided to a patient in a physician’s office, clinic, or hospital outpatient department.

Ambulatory care

All types of health services that are provided on an outpatient basis, in contrast to services provided in the home or to persons who are inpatients. Although many inpatients may be ambulatory, the term ambulatory care usually implies that the patient must travel to a location to receive services that do not require an overnight stay. Many services that once required hospitalization are now considered ambulatory care. Sometimes called outpatient care.

***

Medical services that are provided on an outpatient (non-hospitalized) basis; services may include diagnosis, treatment and rehabilitation.