Insurance claim encounter data that did not pass the front-end edit process and the data need to be corrected and resubmitted.
Tag: RAW
Rejected claim
Insurance claim submitted to insurance carrier that is discarded by the system due to a technical error (omission of erroneous information) or because it does not follow Medicare instructions. It is returned to the provider for correction or change so that it may be processed properly for payment. It cannot be appealed. Also called soft denial .
Rejection
(i) Refusal by an insurer to underwrite a risk. (ii) Sometimes used to refer to the refusal or denial of a claim by an insurer.
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MEDICAL,USA: 1. Refusal by an insurance company to insure an applicant. 2. Refusal by an insurance company to pay an insurance claim. This can occur when a medical service is not a benefit of the health insurance plan.
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A term used for an insurer’s refusal to insure a given risk. This term can also be used to describe the insurer’s refusal to pay a submitted claim.
Rejection insurance
Covers loss due to goods being rejected or condemned by the governmental authorities of the importing state. Insurance is arranged by exporters of consumer goods, including food, that may be perceived to have a health risk. Cover is conditional upon high standards of quality control in the country of origin.
Rejection Risks
Rejection risk Insurance is a form of supplementary coverage offered by the Insurer only to selected clients. This Insurance is concerned with any rejection or condemnation by the government of the country importing edible foods.
Rekindle
To reignite after extinguishment.
Related cases
Clinical cases that have medical procedures with the same diagnosis, same operative area, and same indication.
Relation of earnings to insurance (Health Insurance)
A clause stating that if the insured’s disability income exceeds the income he or she earns, upon disability the benefits will be reduced to the appropriate amount and premiums that were paid toward excess coverage will be refunded to the insured.
Relation of earnings to insurance clause
Provision in some policies that limits the amount of benefits in which the insurance company will participate when the total amount of disability benefits from all insurers is beyond the insured’s usual earnings. Also known as participation limit .
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In disability insurance, a provision that reduced payment to the proportion of policy benefits that the insured’s earnings at the time of disability (or average earnings for two years prior to disability) bear to total disability benefits under all policies, also called the average earnings clause.
Relationship Clause
A clause sometimes found in liability policies excluding liability to members of the insured’s family.