Payment schedule that lists the amount of money paid to an insurance agent for selling and servicing an insurance policy that is high for the first year and has a lower renewal commission for subsequent years.

Payment schedule that lists the amount of money paid to an insurance agent for selling and servicing an insurance policy that has the same commission percentages for premium increments of first and renewal years.

Type of whole life insurance in which premiums are increased once or at a certain time such as every 3 years until the premium reaches a specific level.

Period of formal medical training of a physician after he or she has obtained a Doctor of Medicine (MD) or Doctor of Osteopathy (DO) degree. It is referred to as internship, residency, and fellowship training .

Federal law known as the Balanced Budget and Emergency Deficit Control Act of 1985 .

Section of a policy, law, or association’s bylaws that allows continued eligibility or license for individuals who obtain benefits under the law without meeting all of the criteria regardless of a change in the law.

In diagnostic coding, the code chosen with the highest level of detail and accuracy that corresponds with the patient’s medical record.

Written complaint by a dissatisfied patient submitted to a grievance committee of an insurance plan or program. It may be about availability, delivery, or quality of medical services, utilization review decisions, insurance claims payment, or the contract relationship between a plan member and an insurer. Also see complaint .

Impartial panel of physicians who handle complaints by dissatisfied patients or their representatives against doctors.

Process or system in which a dissatisfied patient or participating provider of a managed care plan can express complaints to get a situation resolved. Such procedures include a due process provision and subject these procedures to a specific and standard adjudication method.
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A procedure which allows an insurer or a provider of benefits to express complaints and seek remedies.