Accredited:
A “seal of approval” for health care facilities. Being accredited means that a facility has met certain quality standards. These standards are set by private, nationally recognized groups that check on the quality of care at health care facilities.
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Accumulation Period:
The timeframe within a policy period in which deductible and out-of-pocket amounts are calculated. For most health insurance policies, the accumulation period is a calendar year.
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Adjustable Life Insurance:
A form of life insurance that allows changes on the policy face amount, the amount of premium, period of protection, and the length of the premium payment period.
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Admitting Privileges:
The right granted to a doctor to admit patients to a particular hospital.
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After Care:
The care or follow-up treatment needed by a patient who has recently undergone surgery, been involved in an accident or has experienced an illness requiring hospitalization.
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Agent:
Licensed salespersons who represent one or more health insurance companies and presents their products to consumers
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Allowed Amount:
The amount of the billed charge that the insurance company deems payable by the plan.
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Ambulatory Care:
All types of health services that do not require an overnight hospital stay.
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Ancillary Services:
Services, other than those provided by a physician or hospital, which are related to a patient’s care, such as laboratory work, x-rays and anesthesia.
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Appeal:
Request made to a payer to reconsider a decision, such as a claim denial or denied prior authorization request. Most appeals must be submitted in writing within a specified period.
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Assignment:
The transfer of the ownership rights of a life insurance policy from one person to another. The term also refers to the document that effects the transfer.
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Authorization:
Approval for coverage that may be required by the health plan before a physician may perform a surgery, order a medical supply, or refer the insured to a specialist.
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