For establishing medical necessity, software computer edits check procedure and HCPCS Level II codes that are connected (linked) to ICD-9-CM diagnostic codes submitted on insurance claims for payment. These must be supported by the documentation in the patient’s medical record.

MEDICAL,USA: Amount stipulated in a contract that estimates a value to be recovered by an individual if the other party breaches. The sum is a measure of damages for a breach, whether it exceeds or falls short of the actual damages.
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Damages that are agreed to either by the court or by the parties to a suit or action.
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Specific sum of money which has been expressly stipulated by the parties to a contract as the amount of damages to be recovered by any party for a breach of the agreement by the other(s).

Course of action of converting all assets into cash and paying all outside creditors according to the order of their preference and distributing what is left over to the owners in proportion and in the order of preference of ownership. Also called liquidation .

Individual who is administering assets in any liquidation proceeding.

An online computer service run from a website where questions may be posted by subscribers. It is a single e-mail address that resends to many others and allows a discussion to continue among a group of participants. Also called distribution list or e-mailing list .

A lawsuit.
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The act of carrying on a law suit.

Unit of measurement used by managed care plans or insurance companies to find out the number of people covered in the contract or policy. The formula for determining this number is to multiply the number of plan members by 2.5.

Insurance policy provision that allows the insured to receive all or part of the policy’s death benefit before the insured’s death dependent on specific conditions. This type of rider may be used to help an insured individual pay medical expenses if he or she develops a terminal illness.