Assessment of an employee that results in the preparation of a narrative medical report prepared and performed by a qualified medical evaluator (QME) and agreed medical evaluator (AME), or the primary treating physician, to prove or disprove a contested workers’ compensation claim.

Facility providing services such as physician’s services related to administrative functions; physical therapy, occupational therapy, speech pathology services, and respiratory therapy; social and psychological services; and prosthetic and orthotic devices.

Program that offers a wide range of services to pregnant Medi-Cal recipients.

Optional insurance that pays for damage to the insured’s automobile caused by events other than collection or rolling the car over such as fire, theft, vandalism, flood, or hail. This type of insurance is frequently required if a person has taken out a car loan.

A type of foundation that designs and sponsors prepaid health programs or sets minimum benefits of coverage.

One of two main types of Correct Coding Initiative (CCI) edits. This type of edit is applied to code combinations in which one of the codes is a component of the more comprehensive code. Note: Only the comprehensive code is paid. Also see mutually exclusive edit.

Under Medicare Secondary Payer guidelines, this is a settlement of differences by mutual consent or adjustment of matters in dispute by mutual concession; a negotiated settlement between parties who are in essentially equal bargaining positions, wherein neither party admits nor concedes that he or she is entitled to less than he or she desires, but accepts less to end the dispute.

Agreement or settlement arrived at, whether in or out of court, for settling a workers’ compensation case after the patient has been declared permanent and stationary. This phrase is used both as a noun and as a verb.