This type of dental care includes dental and oral tissue examination and diagnosis at the request of a physician (MD). It is provided after the physician’s examination and is done to help improve the systemic condition of the whole body and not just one area.
Tag: RAW
Adjustable feature
A cost modification provision found in some reinsurance agreements. Parties agree to adjust final premium rate or final ceding commissions retrospectively, in accordance with the loss experience, by formulas set forth in the agreement.
Adjustable life insurance
A type of coverage wherein changes to the amount of policy, premium, period, or length are permitted.
Adjustable life insurance policy
Life insurance contract that allows the policy owner to change the policy’s plan by changing the amount of the coverage or premium. The insurance company calculates the plan of insurance based on the chosen death benefit and premium. An adjustable life insurance policy can use a plan that ranges from a term insurance policy of short duration to a limited-payment whole life insurance policy.
Adjustable policies
Policies where, at inception, the insured estimates the size of the risk in terms of a key variable such as turnover or wages as in employers’ liability insurance. The premium is based on this estimate but adjusted up or down at the end of the year when the actual figure is declared by the insured. Any return made to the insured is subject to a minimum premium.
Adjustable premium
The agreed right of a company to modify the insured person’s premium payments under certain specified conditions. Seen in health insurance.
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The right of an insurer to change the premium rate on classes of insureds, or blocks of business at the time of policy renewal.
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See ADJUSTABLE POLICIES.
Adjusted average per capita cost (AAPCC)
Estimated average cost of Medicare benefits in a given region for an individual. It is based on criteria such as age, sex, institutional status, Medicaid, disability, and end-stage renal disease (ESRD) status. Centers for Medicare and Medicaid Services (CMS) uses AAPCC as a basis for making monthly payments to managed care plans.
Adjusted CETV
The cash equivalent transfer value, worked out in the prescribed manner (the Welfare Reform and Pensions Act 1999), to establish a member’s pensions rights on divorce. The CETV is a lump sum value in current terms of the rights accrued within a member’s pension scheme.
Adjusted clinical groups (ACGs)
System developed by Johns Hopkins University that is a comprehensive family of measurement tools designed to help explain and predict how health care resources are delivered and consumed. ACGs are based on building blocks called aggregated diagnosis groups (ADGs). See aggregated diagnosis groups (ADGs).
Adjusted community rate (ACR)
Annual calculation of premium (payment rates) that health plans would have received for their Medicare enrollees to provide Medicare-covered benefits if paid their private market premiums. This is done to adjust subsequent year supplemental benefits or premiums to return any excess Medicare revenue above the ACR to enrollees. Also called average community rate (ACR). See adjusted average per capita cost (AAPCC).