Utilization Review (utilization Management)
Integral part of managed care health plans designed to control and limit medical expenses. This review includes: requirement of certification for admission to a health care facility; continuous analysis of the reasons for the patient to remain in the health care facility; projected date for release of the patient; and cost-effective ways of handling patients with catastrophic illnesses.
Popular Insurance Terms
Partial payment of medical service expenses required in group health insurance, in addition to the membership fee. For example, for each visit of a physician a member may be required to pay ...
Standard for insurance regulation in New York State and a model for insurance regulation elsewhere. For example, the standard fire policy was first adopted in New York State. Similarly, ...
Intense combustion resulting in a flame or glow. In order for the fire peril to be covered under property insurance, the fire must be a hostile fire, not a friendly fire. ...
Minimum standard of financial health for an insurance company, where assets exceed liabilities. State laws require insurance regulators to step in when solvency of an insurer is threatened ...
Purchasing bond investments that mature at different time intervals. ...
Accounting procedures that defer the full funding of a life insurance net level premium reserve to accommodate the policy acquisition cost in the early years of a policy. First-year policy ...
Regulation set forth by the national association of insurance commissioners (naic) to govern life insurance sales illustrations. Includes the following major provisions: POLICY OWNER must ...
System of charges to an insured that fluctuates according to the loss experience of that insured. This is a form of experience rating. ...
Contractual agreement between two parties in which they agree to exchange a stream of interest payments on either a fixed rate for a floating rate or a floating rate for a fixed rate. The ...
Have a question or comment?
We're here to help.