The Rantings of the barely human.
1. To select information from a patient’s medical record using hard copy or electronic equipment for statistical purposes or to submit an insurance claim for reimbursement.
2. At the end of a patient’s hospital stay, the attending physician prepares a report that summarises the diagnosis, treatment, and results and outlines any further treatment after discharge. This is referred to as a discharge summary.
See Also: Case Summary Card.
Individual who electronically or manually selects and extracts information from a patient’s medical record from computer files or paper files. Coded diagnoses can be used in a facility to track morbidity and mortality, infectious disease, and index disease information for quality of care and utilisation review. Another use for extracted data is the submission of insurance claims.
Under the Medicare programme, incidents or practises that are not usually considered fraudulent but are inconsistent with accepted sound medical business or fiscal practises (e.g., billing for noncovered services, excessive charges, improper billing practises, billing Medicare beneficiaries at a higher rate than other patients, submitting bills to Medicare instead of to primary third-party payers, billing for medically unnecessary services, violating the Medicare particpation agreement, billing for medically unnecessary services, violating the Medicare particpation agreement and billing for medically unnecessary services.
Affiliated Contractor.
American College of Allergy, Asthma and Immunology.
Pharmaceutical care in managed health care environments is a national professional society dedicated to the concept and practise of pharmaceutical care. The mission of the AMCP is to promote the development and application of pharmaceutical care in order to ensure that all individuals receive appropriate health care outcomes. Its sole purpose is to represent managed care pharmacy’s views and interests.
A life insurance policy rider that allows the insured to receive the proceeds of a life insurance policy before death under certain conditions, such as terminal or catastrophic illness, the need for long-term care, or confinement in a nursing home.
Death benefits are typically paid to an insured’s beneficiaries upon death. The accelerated death benefit is a life insurance policy option that provides funds to an insured individual while that person is still alive, but during what is medically believed to be the insured’s final year or two of life. The purpose of the option, which first appeared in the 1980s, is to provide money to the insured to cover medical and medically related expenses. Prior to death, up to 80% of the value of the death benefit can be withdrawn and used for any purpose by the policyholder. In addition to medical expenses, the funds can be used for a vacation, home improvements, hiring medical home-care personnel, or experimental care. Although a specific life insurance policy may not explicitly mention an accelerated death benefit, many companies pay it as a matter of practise. The benefit payments made to the policyholder while the insured is alive are deducted from the death benefits, and the beneficiaries receive only the balance that is left when the insured dies. The accelerated death benefit is handled differently by each insurance company. While some people deduct the amount directly from the death benefit, others consider the payments to be loans and charge interest on them. As a result, upon the death of the insured, the loan and any accrued interest will be deducted from the amount paid to the beneficiaries.
Also known as Living Benefits and Accelerated Death Benefit
Temporary partial advance of funds to medical providers due to insurance claim payment delays.
The overall assessment of medical care available to an individual or group. In determining the acceptability of health services provided, the individual considers factors such as cost, quality, results, and convenience of medical care, as well as provider attitudes.
See Also: Accessibility and Availability.
1. A Medicare Part B agreement in which a Medicare participating physician agrees to accept 80% of the approved charge from the fiscal intermediary and 20% from the patient after the patient’s deductible has been met.
2. Transfer of the legal interest in an insurance policy to another person, typically when property is sold; or in life insurance, only valid with the insurance company’s consent.
3. Transfer of an individual’s right to receive payment under an insurance contract.