Word that means “insurance” that is commonly used in Canada and Great Britain.
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Synonym for Insurance. Used commonly for the life business and in the traditional form of marine policy. Charles Babbage in 1826 suggested that assurance was a contract on the duration of life which must either happen or fail and insurance is a contract relating to any other uncertain event which may partly happen or partly fail but the distinction has never been universally accepted.
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UK: a term commonly used to distinguish insurance business providing benefits related to the duration of human life from other types of insurance (but for practical purposes the terms assurance and insurance are interchangeable).
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UK: Means an insured event that is certain to happen, e.g. in an endowment policy, the life assured will either survive the policy term or die within it. In contrast insurance is taken to mean events, e.g. road accidents that may or may not happen to the individual. The terms have often been used interchangeably although insurance is now the main term.
HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating acute treatment services.
Type of managed care contract between Medicare and a payer or a payer and a provider wherein patients receive care during the entire term of the contract even if actual costs exceed the payment established by the agreement.
See: claim attachment.
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The act of taking in to custody of the law either the person or the property of someone under and by virtue of an order of court.
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The legal process of taking possession of a defendant’s property when the property is in dispute.
Age of the insured as of the insured’s last birthday.
Medical staff member who is legally and primarily responsible for the medical care and treatment given to a patient and who would normally be expected to certify and recertify the medical necessity of the number of services rendered for the patient’s care while in the hospital. An attending physician who has a patient admitted to the hospital may be referred to as the admitting physician.
Form that, when completed, provides the insurance company with information about the patient’s injury or illness, diagnosis, and treatment. An APS form is completed when the insurance company requests information to decide whether to insure an individual or, if insured, when settling an insurance claim.
Disenrollment from a health insurance plan expressed as a percentage of total membership. For example, a managed care plan with 40,000 members with a 2% attrition rate would need to gain 800 new members each month to retain the initial 40,000 covered lives.
HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating item(s) used with urological, ostomy, or tracheostomy supplies. Use of this modifier affects Medicare payment.
1. Formal, methodical examination or review done to inspect, analyze, and scrutinize the way something is being done (e.g., bookkeeping practices, medical record documentation, insurance claim filing) to determine operational efficiency. 2. In the Medicare program, a process to ensure that the fiscal intermediary reimburses providers based only on costs associated with patient care.
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Some policies (such as workers compensation) are written subject to an audit. Since workers compensation premium is based on the insured’s payroll, the insurer is entitled to audit the insured’s records at the end of the policy to verify that it has collected an adequate premium for the amount of payroll to which it was exposed.
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US: A survey of the financial records of a person or organization conducted annually (in most cases) to determine exposures, limits, premiums, etc.
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Survey of an insured’s records to determine the premium which should be paid to the Insurer for protection furnished and perhaps for other purposes, such as compliance with loss control recommendations.