Software program created by the Office of the Inspector General (OIG) that helps to access provider claims data and to limit the need for the OIG to send multiple requests to insurance carriers for claims information. It can assist in detection of aberrant billing practices of providers.
Insurance Encyclopedia
ARHCP
See: Association of Registered Health Care Professionals (ARHCP).
Arise out of employment and in the course of employment (AOE/COE)
In workers’ compensation cases, a criterion for determining liability, or whether a claim is or is not compensable. AOE refers to how the activity of work led to the injury in question. It is one of the legal tests that must be met for a medical condition to be covered by workers’ compensation insurance. COE refers to how the activity the employee was engaged in at the time of injury must grow out, or be incidental to, the employment.
Arising Out of Employment
Refer: “Accident, arising out of and in the course of employment.”
Arithmetic mean length of stay (AMLOS)
In the Medicare program, the average number of days for a patient’s DRG inpatient hospital stay. This figure is used to determine payment for outlier cases and to predict occupancy rates. To obtain this number, use this formula: total number of patient days divided by (÷) the total number of hospital admissions for a specific time period. It is also known as average length of stay (ALOS).
Armed services disability
Disability occurring or aggravated while the patient is in military service.
Armoured car insurance
Covers loss of customers’ money carried in armoured cars and physical loss or damage to customers’ property whilst on insured premises, in transit, on a pavement or at an automatic telling machine. Underwriting and rating takes account of: premises to be insured; company’s history; five-year loss history; number of armoured vehicles; physical security measures applied to vehicles and premises; annual revenue figures; estimated value of cash to be carried during year.
Arranged Total Loss (Marine, Hull)
An agreement between a hull underwriter and the assured ship owner, whereby the underwriter is prepared to pay a compromised settlement on a total loss basis because, although, the estimated cost of repairs does not justify a constructive total loss, repairing the ship would be an uneconomical proposition in view of its market value and the high cost of repairing the damage. The settlement, usually, allows the assured to retain the wreck. Refer: “Compromised total loss:.
Arranged total loss/comprised total loss
Marine term describing a settlement agreed between the insurer and the insured where the cost of carrying out repairs is uneconomical nothwithstanding that the cost is less than the full insured value. When appropriate the principle is also adopted in other forms of property insurance.
Arranging deals in investments
A regulated activity order which means making arrangements for another person (as principal or agent) to buy, sell, subscribe for or underwrite a particular investment which is: a designated investment, funeral plan contract, underwriting capacity of a Lloyd’s syndicate, a pure protection contract, general insurance contract or rights to or interests in particular investment categories.