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.

List of a health insurance plan’s categories for eligible individuals and their dependents.

Situation that indicates a deteriorating financial condition of a retirement plan that needs to be reported to the Pension Benefit Guaranty Corporation (PBGC).

Health plan benefit that is planned, has been reported to the insurance company, but has not yet occurred (e.g., scheduled surgery).

Written statements by an individual applying for insurance about health history, family health history, occupation, and other personal information that must be substantially correct. Such representations are fraud only if they pertain to an insurance risk and were made with the intent to deceive.