Review done after claims of medical and financial records have been submitted by an insurance company or Medicare representative to investigate suspected fraudulent and abusive billing practices (retrospective review).
Insurance Encyclopedia
External Cause (E Code)
SubstancePoisoningAccidentTherapeutic UseSuicide AttemptAssaultUndeterminedAcetylsalicylic acid…965.1E850.3E935.3E950.0E962.0E980.0
External company
An insurance company whose head office is situated in a country outside the European Community.
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A Company not having its head office within the Indian territory.
External dependencies
Risks attaching to a business as a result of dependencies on supplies from, or sales to, outside enitities. Loss of trade may be due to occurrences, e.g. fires, at the premises of customers and/or suppliers. Risk man agement involves a scrutiny of external dependencies and internal dependencies. Business interruption policies can extend to cover loss of trade due to damage occurring at the premises of customers and/or suppliers, utility suppliers, loss of attraction, etc.
External disclosure
Release, transfer, or divulging of confidential information beyond the boundaries of the provider health care organization or other entity that collected the data.
External fixation
Method of using metal pins and an attaching mechanism to hold together the fragments of a fractured bone or for temporary treatment of acute or chronic bone deformity.
External insurer
Insurer whose head office is located outside the UK and other than an EEA insurer, a Swiss general insurer or an insurer subject to special rules.
External means
Bodily injury, for personal accident policy purposes, must, inter alia, be caused by ‘external and visible’ means. This is to make it clear that the bodily injury must be due to some outside event clearly visible as distinct from internal physical defects – the words are used as the antithesis of ‘internal means. Exceptions to this strict meaning arise in connection with the inhalation of gas or the accidental taking of poison.
External member
A Lloyd’s underwriter who does not fall within the definition of a working member.
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A member who is not a working member or a nominated member.
External Name
an underwriting member of Lloyd’s who plays no active part in the underwriting (contrast Active Underwriter).