Form sent by an insurance company’s home office to a branch office that condenses important information about a new case or a change in an existing case. Also known as an abstract.

Database of billed insurance claims from which CMRI selects the specific review category samples.

In managed health care, payment to specialists such as orthopedists, urologists, and oncologists based on either referral or episode of care of the patient. Also called contract capitation.

Costs of the service when payment was made rather than when the service was performed.

Cash paid, draft redeemed or drawn, for settlement of a group insurance claim.

In a medical practice, the amount of actual cash generated and available for use by the medical practice within a given period of time.

Payment to the insured by the insurance company after submission of an insurance claim. The insured may assign these benefits directly to the provider. Payment may or may not fully cover the insured’s total costs for the service.

Life insurance policy that has a dividend option under which the dividends are paid to the policyholder in cash.