Proficiency obtained through work by the insured that he or she can apply to another job using similar physical or mental limitations caused by a disability.

Group insurance plan that is changed from one insurance company to another.

Assessment of an insurance risk and establishment of a rate for a specific level of benefits that is competitive and matches with the current experience rating system.

Ability of an individual to move in and out of a bed or chair. Also see activities of daily living (ADLs) .

1. Patients who receive treatment on an episodic basis and are not part of a facility’s regular caseload (i.e., patients who have not been permanently transferred to a facility for ongoing treatment). 2. Patients who temporarily live in a locale but continually move from one region to another. These types of patients may cause collection problems, so initially gathering comprehensive and accurate demographic data is important.

Bed in a skilled nursing facility for a patient who does not need intense observation as in an acute care unit. Also see intermediate care .

Facility used instead of or before discharge to an extended care facility.

Under the Medicare outpatient prospective payment system (OPPS), certain drugs, biologicals, and devices are eligible for payments in addition to the ambulatory payment classification (APC) payment (i.e., the costs are passed through [around] the APC system).

Under the Health Insurance Portability and Accountability Act (HIPAA), a software tool for accepting an electronic data interchange (EDI) transmission and converting the information into another format or for converting a non-EDI data file into an EDI format for transmission. Also known as EDI translator .