Limited examination of the affected body area or organ system and other symptomatic or related organ systems.

Phrase used when the physician has documented the patient’s chief complaint giving a brief history of the present illness and has completed a problem pertinent system review.

Documentation must include the chief complaint, a brief history of the presenting illness (HPI), and a problem pertinent review of systems (ROS).

Performance and documentation of at least six elements identified in a table by a bullet (•) in one or more organ system(s) or body areas(s).

Performance and documentation of at least six elements identified in a table by a bullet (•) whether in a shaded or unshaded box.

Growth of a health insurance plan’s network either geographically or in the amount of hospital facilities and providers added.

Total dollar amount of insurance claims within a specific period of time that are predicted to be paid.

Deaths that are anticipated to occur to a certain group in a specific time based on the statistical figures in the mortality table. It is usually shown as a ratio of expected death insurance claim payments to premiums.

1. Medicare+Choice organization’s second look at whether it will provide a health service. A beneficiary may receive a fast decision within 72 hours when life, health, or ability to regain function may be jeopardized. 2. Appeal for medical service, thought by the physician, to be urgent.