Determination that the patient’s private fee-for-service plan makes on whether or not it will pay for a particular medical service.

As specified in the Patient Self-Determination Act, this is a legal document prepared by an individual that gives directions about his or her wishes in the event he or she becomes incapacitated and not able to make decisions. It designates a person to make medical decisions. An advance directive includes such documents as do-not-resuscitate (DNR) order, durable power of attorney, right to die document, and living will. Also called health care advance directive or living will.

Certification of those professionals who take care of seriously injured or ill patients.

Certification offered by the Board of Advanced Medical Coding (BAMC) to physician and facility coders who successfully complete the qualifying examination. See Board of Advanced Medical Coding (BAMC).

Registered nurse who has advanced education and clinical training in a health care specialty area.

Insurance company home office division that is responsible for giving technical and sales help to insurance agents about estate planning and business insurance. Also known as estate planning department.

Denied or incorrectly paid health benefit under HMO, PPO, or POS managed care plans that follow federal regulations mandated under the Employee Retirement Income Security Act (ERISA).

Unfavorable, detrimental, or pathologic reaction to a drug that occurs when appropriate doses are given to humans for prophylaxis (prevention of disease), diagnosis, or therapy.

In a 401(k) defined-contribution pension plan, a firm that helps the employer choose a provider, select the investment options, and make any other decisions about the plan.