In assumption reinsurance, each policyholder is sent an official document (certificate) when the policy has been ceded about a notice of the assumption and information about the new insurer.

1. State license to operate as a health maintenance organization (HMO). 2. Insurance company’s document that grants authority to a particular agent or group of agents to act on behalf of the insurer. 3. Certificate issued by a state’s insurance department that authorizes an insurance company to issue certain types of insurance in the state.

Federal document that legally protects researchers from having to disclose information about research participants as a result of a subpoena or court order. It is for projects involving information of a sensitive nature that, if released, could harm participants. See sensitive information.

Document given to an insured by the insurance company or any employer that offers a health plan. It describes the benefits in detail under the policy issued. It is required by state law. Also called evidence of coverage (EOC), benefit plan, insurance policy, subscriber agreement, subscriber certificate, and subscriber contract.

1. Document issued by an insurance company and given to the beneficiary of a life insurance policy that states a guaranteed minimum interest rate and the frequency of interest payments. 2. Short-term certification, 12 months or less, of a specific portion of debt due by the federal government to individual holders, bearing a fixed rate of interest.

1. Certification by a provider to an insurance carrier that a medical service or procedure is medically necessary because of the patient’s condition. 2. Form required by Medicare that allows the patient to use certain durable medical equipment prescribed by a physician or one of the physician’s staff. 3. In Medicare fraud, to complete a CMN for patients not personally and professionally known by the physician.

Document that is required for an independent medical expert to review a patient’s medical record and certify that a claim has merit before a formal medical liability lawsuit is filed.

Document of approval issued by a state or government agency that legally allows an organization or health care institution to construct or modify a health care facility, incur a major capital expenditure, obtain expensive medical equipment, or offer a new or different health service. An investigation is done before receiving the CON to make sure the facility or service meets the needs of those for whom it is intended. Also referred to as planning approval.

Document issued to a laboratory to perform only waived tests. These are simple examinations or procedures that use methodologies that are so easy and accurate that the likelihood of erroneous results is negligible and poses no reasonable risk of harm to the patient if the test is performed incorrectly.

Amendment or supplement to the certificate of insurance.