Health insurance policy provision that states the greatest dollar amount paid for the daily inpatient hospital room rate.
Insurance Encyclopedia
Maximum defined data set
Under HIPAA, necessary data elements for a particular standard based on a certain implementation specification. The sender who creates the transaction may include whatever data the receiver might require. The receiver of the data may ignore any part of the data that is not necessary to carry on its portion of the business transaction unless some unnecessary data are necessary for coordination of benefits with another insurance company.
Maximum disability policy (Health Insurance)
Disability insurance that allows multiple claims for multiple different disabilities, with stated limits for each claim.
Maximum enrollee out-of-pocket costs
Medicare beneficiary’s highest dollar liability amount (copayments, deductibles, and coinsurance) for a specified time period.
Maximum Estimated Loss (EML)
A worst loss that is likely to occur because of a single event.
Maximum fee schedule
Third-party reimbursement arrangement in which a participating provider agrees to accept the contract’s schedule of allowances as the total fee for each covered health care service rendered.
Maximum foreseeable loss (MFL)
A property underwriter’s estimate of the cost in the event of a total loss where all loss control systems (e.g., sprinklers and firewalls) fail. See Probable maximum loss (PML).
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Largest loss (usually property loss, but sometimes combined property loss and loss of income) which can occur under the most adverse conditions reasonably foreseeable.
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US: The worst loss that is likely to occur because of a single event.
Maximum Foreseeable Loss / Probable Maximum Loss (PML)
The worst loss that is foreseeable or probable to occur because of a single event. This term is typically used in property reinsurance.
Maximum liability method
See: INDEPENDENT LIABILITY METHOD with which it is compared.
Maximum lifetime benefits
Total amount a health insurance plan will pay for medical care for any individual insured.