Evaluation of the premium and claim expense of an existing policy to set renewal premium rates and create terms for the next year of insurance.

Insurance policy that gives coverage for a dwelling occupied by a renter that gives coverage against explosion, fire, hail, riot/civil commotion, theft, vandalism, volcanic eruption, windstorm, and accidental discharge of steam from a heater.

Term that refers to informal revisiting of a claim payment decision that has been made by a Medicare fiscal intermediary. Situations for reopening are (1) after appeal rights are exhausted, (2) after the time limit for requesting an appeal has expired, (3) 12 months to 4 years after the date of the initial decision, (4) when a decision is unfavorable, (5) to correct a clerical error for fraud, or (6) in response to a court order. Also called revisit .

1. Remedial action taken after all appeal rights of a denied insurance claim are exhausted, to reexamine or question the correctness of a determination, a decision, or cost report otherwise final. 2. To resolicit an insurance plan to an employer for enrollment of his or her employees who were not previously enrolled.

Insurance claims in which information has been changed, corrected, and resubmitted and is not the same as a duplicate claim.

Medicare Part B recurring services billed monthly or at the conclusion of outpatient treatment such as cardiac rehabilitation services; home health visits; kidney dialysis treatments; psychological services; rental of durable medical equipment; therapeutic nuclear medicine; therapeutic radiology; respiratory, physical, and occupational therapy; and speech pathology. Also called recurring outpatient services or series outpatient services .

Type of insurance coverage that protects personal possessions and, if damaged, will replace those items without depreciation.

Insurance coverage that protects property and, if damaged, will replace it without deducting for depreciation. However, usually there is a limit to the amount that is stated in the insurance agreement.

System used to check the quality of care delivered by health plans. Report cards provide information on how well a health plan treats its members, keeps them healthy, and gives access to needed care. Report cards can be published by states, private health organizations, consumer groups, or health plans. The Health Plan Employee Data and Information Set (HEDIS) is regarded as a report card by some insurance companies.

Mandated medical review document that outlines savings realized each quarter as a direct result of medical review activities by Medicare administrative contractors.