Association that validates a health care professional’s background, licensing, and schooling, and follows continuing education and other measures of professional performance.
Insurance Encyclopedia
Credentialing
1. Generic term that refers to either licensing or certification. 2. Act of reviewing and evaluating qualifications such as education, training, experience, medical degrees, licensure, other credentials, malpractice, and any disciplinary record of a medical provider for quality assurance for the purpose of granting hospital staff membership to give patient care services. Periodically, a check of the status of staff qualifications is done and is referred to as recredentialing . 3. Process by which a managed care plan endorses that a physician is competent to render medical services to members of the plan. Also see economic credentialing.
Credentialing (Health Insurance)
The process of endorsing a health care provider to participate in or provide care under a health care plan.
Credibility
A statistical measure of the reliability of experience data, based on the size of the sample.
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Degree of statistical confidence which properly can be ascribed to data on part losses as a predictor of future losses. In general, credibility increases with the number of past losses studied, the similarity of the exposures giving rise to part losses and, with respect to predictions of future losses, the absence of significant changes in future conditions.
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MEDICAL,USA: Percentage weight given to an insured group’s past claim history. It is done to set the premium for future expected claims or to determine claim charges for experience refund purposes.
Credibility factor
See: credibility percentage.
Credibility percentage
Amount of credit given to a group’s actual insurance claims experience in establishing a projection of future claims or in calculating a dividend. Also called credibility factor.
Credit
1. From the Latin credere, meaning “to believe” or “to trust”; trust in regard to financial obligation. 2. Accounting; entry reflecting payment by a debtor (patient) of a sum received on his or her account.
Credit Accident Insurance
Insurance to relieve a debtor of his obligations to pay during periods of inability to earn as a result of accidental injury
Credit card forgery
A criminal act involving the illegitimate use of credit cards to obtain goods or money. Limited coverage for such losses is automatically provided in most homeowners policies.
Credit Card Forgery (Credit Card Insurance)
This protects the insured against losses caused by forgery in the use of credit cards or alteration of them or of any other written instruments connected with them.