In health insurance, funds set aside for deferred maternity benefits and for other claims that have happened but are contingent on a future event.

Process of creating additional policy reserves.

For Medicare, a physician who is participating in an approved graduate medical education (GME) training program or one who is not in an approved program but who is authorized to practice only in a hospital setting. This includes interns and fellows where direct GME payments are made by the fiscal intermediary.

System that provides a comprehensive, accurate, standardized, reproducible evaluation of each long-term care facility resident’s functional capabilities and helps staff to identify health problems. This assessment is performed on every resident in a Medicare and/or Medicaid-certified long-term care facility including private pay.

Facility that provides treatment for substance (alcohol and drug) abuse to live-in residents who do not require acute medical care. Services include individual and group therapy and counseling, family counseling, laboratory tests, drugs and supplies, psychological testing, and room and board.

Health care facility that provides treatment for alcoholism, drug abuse, and psychiatric problems. These facilities are usually accredited by The Joint Commission and must be licensed by the state.

Temporary or permanent medical condition that results after treatment for an illness or injury.

Term used in disability income insurance for disability that is not work related. It is the payment of partial benefits when the insured is not totally disabled.

Inability to perform one or more job duties or inability to do usual work for the time period of partial disability that follows a period of total disability.