Reimbursement made by Medicare for services for which a third-party (primary payer) is responsible. The provider (physician) requests payment from the Medicare Secondary Payer because a lengthy processing delay (more than 120 days) by the third-party payer is expected. The provider must agree to send a refund or request for reconsideration from Medicare within 60 days of the third-party payer’s payment.

Type of premium receipt given to the applicant on payment of the initial premium. The life insurance policy becomes effective before it is actually issued only on acceptance or approval of the application (i.e., the proposed insured is found to be insurable). Also called conditional receipt.

Circumstance in which Medicare is billed as the primary payer for a temporary period of time.

Insurance policy renewal provision that grants the insurer a limited right to refuse to renew a health insurance policy either to a stated date, at the end of a premium payment period, or at an advanced age.
***
A continuation provision in health insurance under which the insurer may not cancel the policy during its term but can refuse to renew under specified circumstances.

MEDICAL,USA: 1. Illnesses, diseases, injuries, pregnancies, bodily defects or abnormalities, mental illnesses, alcoholism, or drug or chemical dependencies. 2. Part of an insurance policy that states the insured’s obligations and those of the insurance company in order for the policy to be in effect.
***
UK: Parts of a policy that must be complied with by one party or the other. Conditions may be implied by law or expressed, i.e. set out in the policy. The effect of a breach by the insured depends upon whether it relates to a condition precedent (things to be done before the contract is concluded, e.g. utmost good faith); a condition subsequent (things to be done during the policy certain stanterm, e.g. maintainin dards); a condition precedent to liability (things to be done before the insurer is liable for a particular loss, e.g. proper notification). See WARRANTY.
***
US: Provisions inserted in an insurance contract that qualify or place limitations on the insurer’s promise to perform.
***
See: policy conditions.
***
These are provisions of an insurance policy which state either the rights and duties of the insured or the rights and duties of the insurer. Typical condition have to do with such things as the insured’s duties in the event of loss, cancellation provisions, and the right of the insurer to inspect the property.

Federal requirements that health care facilities must meet to be eligible to participate in the Medicare program and receive payments for medical services rendered to beneficiaries. These conditions include meeting a statutory definition of the particular institution or facility, conforming to state and local laws and having an acceptable utilization review plan. Surveys to determine whether facilities meet conditions of participation are made by the appropriate state health agency.

In a workers’ compensation case, a meeting of the injured employee’s attorney and the insurance company’s lawyer before an administrative judge who will make a decision about an industrial claim in dispute.
***
A group of vessel operators joined together for the purpose of establishing freight rates. RoRo/Container Vessel – Ship designed to accommodate containers and roll-on-roll-off cargo. It can be self-sustaining. RoRo/Container/Break-bulk vessel – designated to accommodate three types of cargo, usually self-sustaining.

1. Private information about one individual entrusted to another person that must be protected from unauthorized disclosure to any third party. 2. Information that may not be freely disclosed.