See: manual rate .
Tag: MEDICAL
Manual rate
MEDICAL,USA: Cost of a unit of insurance protection (premium) obtained from the insurance company’s standard rating table that appears in the underwriting manual. Also referred to as manual premium rate or manual rating .
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Premium rate specified in a Insurer’s or rating bureau’s manual for a particular line of Insurance.
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The cost of insurance protection as quoted in the rating manual—the rate listed on the state rate pages in the Basic Manual for a given class code. These rates are usually determined on the basis of per $100 of payroll. The term may also refer to rates developed by the application of a recognized rating plan.
Manual rating
See: manual rate .
Manual transmittal
Online instruction manual that the Centers for Medicare and Medicaid Services (CMS) transmits to Medicare carriers. It includes guidelines for processing and paying Medicare claims, preparing reimbursement forms, billing procedures, and Medicare regulations. The manual system has been replaced by online, Internet-only manuals (IOMs)—the, National Coverage Determinations Manual, Medicare Benefit Policy Manual, Publication 100 , one-time notifications, and manual revision and update notices. This information is helpful to providers when dealing with Medicare contractors for issues such as researching information, claims processing, and appealing denials. Formerly known as Medicare Coverage Manual (MCM) . See Medicare Coverage Manual (MCM) .
Mapping
See: data mapping, crosswalk, and crosswalking .
MAR
See: medication administration record (MAR) .
Margin
Insurance provision to allow for an error when estimating premium rates and reserve requirements.
Market area
Specific geographical region where an insurance plan’s chief market potential is located. It may not be the same as its service area, but many times it can overlap.
Market basket
See: hospital market basket .
Market basket index
Table used by the Centers for Medicare and Medicaid Services (CMS) to compute and update the indexes for most facilities. It takes into consideration three elements: a set of input categories (labor, supplies, purchased services); a set of price proxies that represent price levels for the input categories; and a fixed set of weights (proportions) that represent the importance of each input category in providers’ input expenditures for the base year. The formula is to take the actual or projected values of the price proxies for a year, multiply them by the category weights, and total them to get the overall market basket index value for the year. For physicians’ office practices, see Medicare Economic Index (MEI) .