Insurance claim that is submitted to the insurance carrier in a timely manner and meets all other claims filing requirements of the third-party payer (e.g., mandatory second opinion or prior authorization or approval before treatment).

In workers’ compensation cases, take preventive measures to guard against aggravation of an impairment (i.e., if the restrictions were exceeded, the injured worker may be at risk for additional injury).

First draft of new regulations for legislation developed by the Secretary of Health and Human Services. After a public comment period, a final draft is created and adopted.

For-profit facility owned by individuals, partners, or a corporation. Also referred to as an investor-owned hospital.

Proportionate reduction in the amount of insurance benefits payable as provided in the contract. Some examples for proration would be because the insured changed to a more perilous job, because benefits payable by all the insured’s disability insurance are more than his or her current earnings over the preceding 2 years, or because the insured is actually older than stated in a life insurance application.

MEDICAL,USA: Act of modifying an insurance policy’s benefits because of some type of change (e.g., insured’s occupation).
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The adjustment of the benefits paid by reason of change of occupation or the existence of other Insurance covering the same accident or disability.
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The modification of policy benefits because of a change in the insured person’s occupation or the existence of other insurance.

Good and bad parts of treatment for a health problem (e.g., a medicine may help the patient’s pain [pro], but it may cause an upset stomach [con]).

To submit a charging document to a court; seek a grand jury indictment against person(s) accused of committing criminal offenses.