See: reinsurer.
Tag: MEDICAL
Assumptions
Values relating to future trends in certain key factors that affect the balance in the trust funds. Demographic assumptions include fertility, mortality, net immigration, marriage, divorce, retirement patterns, disability incidence and termination rates, and changes in the labor force. Economic assumptions include unemployment, average earnings, inflation, interest rates, and productivity. Also called demographic assumptions.
Assurance
Word that means “insurance” that is commonly used in Canada and Great Britain.
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Synonym for Insurance. Used commonly for the life business and in the traditional form of marine policy. Charles Babbage in 1826 suggested that assurance was a contract on the duration of life which must either happen or fail and insurance is a contract relating to any other uncertain event which may partly happen or partly fail but the distinction has never been universally accepted.
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UK: a term commonly used to distinguish insurance business providing benefits related to the duration of human life from other types of insurance (but for practical purposes the terms assurance and insurance are interchangeable).
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UK: Means an insured event that is certain to happen, e.g. in an endowment policy, the life assured will either survive the policy term or die within it. In contrast insurance is taken to mean events, e.g. road accidents that may or may not happen to the individual. The terms have often been used interchangeably although insurance is now the main term.
AT
HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating acute treatment services.
At risk contract
Type of managed care contract between Medicare and a payer or a payer and a provider wherein patients receive care during the entire term of the contract even if actual costs exceed the payment established by the agreement.
Attachment
See: claim attachment.
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The act of taking in to custody of the law either the person or the property of someone under and by virtue of an order of court.
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The legal process of taking possession of a defendant’s property when the property is in dispute.
Attained age
Age of the insured as of the insured’s last birthday.
Attending physician
Medical staff member who is legally and primarily responsible for the medical care and treatment given to a patient and who would normally be expected to certify and recertify the medical necessity of the number of services rendered for the patient’s care while in the hospital. An attending physician who has a patient admitted to the hospital may be referred to as the admitting physician.
Attending physician’s statement (APS)
Form that, when completed, provides the insurance company with information about the patient’s injury or illness, diagnosis, and treatment. An APS form is completed when the insurance company requests information to decide whether to insure an individual or, if insured, when settling an insurance claim.
Attrition rate
Disenrollment from a health insurance plan expressed as a percentage of total membership. For example, a managed care plan with 40,000 members with a 2% attrition rate would need to gain 800 new members each month to retain the initial 40,000 covered lives.