Documentation must include the chief complaint, a brief history of the presenting illness (HPI), and a problem pertinent review of systems (ROS).

Performance and documentation of at least six elements identified in a table by a bullet (•) in one or more organ system(s) or body areas(s).

Performance and documentation of at least six elements identified in a table by a bullet (•) whether in a shaded or unshaded box.

Growth of a health insurance plan’s network either geographically or in the amount of hospital facilities and providers added.

Total dollar amount of insurance claims within a specific period of time that are predicted to be paid.

Deaths that are anticipated to occur to a certain group in a specific time based on the statistical figures in the mortality table. It is usually shown as a ratio of expected death insurance claim payments to premiums.

1. Medicare+Choice organization’s second look at whether it will provide a health service. A beneficiary may receive a fast decision within 72 hours when life, health, or ability to regain function may be jeopardized. 2. Appeal for medical service, thought by the physician, to be urgent.

Fast decision from the Medicare+Choice organization about whether it will provide health service. A beneficiary may receive a quick determination within 72 hours if life, health, and ability to regain function may be jeopardized.

1. Issuance of checks, disbursement of cash, or electronic transfer of funds made to liquidate an expense regardless of the fiscal year the service was provided or the expense was incurred. 2. When used in the discussion of the Medicaid program, expenditures refer to funds spent as reported by the states. Also called outlay .