A review of medical treatment, conducted by a medical staff with equal training to those who provided the care.
Insurance Encyclopedia
Peer review committee
See: peer review group.
Peer review group
Several local physicians who come together to solve insurance claim disputes and support ethical medical practices in the community. Sometimes referred to as a peer review committee .
Peer review organization (Health Insurance)
Physicians hired by the federal government to review the service provided to Medicare subscriber by the Medicare approved facilities.
peer review organization (PRO)
See: Quality Improvement Organization (QIO) program.
Pelvic examination
Diagnostic procedure performed by a physician in which the external and internal genitalia are physically examined by inspection, palpation, percussion, and auscultation.
PEN
See: parenteral nutrition (PEN).
Pen, The
See: Managing general agent (MGA).
Penalize
To inflict a burden or penalty on an individual.
Penalized claim
Insurance claim submitted to an insurance carrier that did not pass the claim edits and a penalty was applied, thus reducing payment. Also see downcoding.