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Insurance

Insurance is a promise of compensation for specific potential future losses in exchange for a periodic payment. Insurance is designed to protect the financial well-being of an individual, company or other entity in the case of unexpected loss. Some forms of insurance are required by law, while others are optional. Agreeing to the terms of an insurance policy creates a contract between the insured and the insurer. In exchange for payments from the insured (called premiums), the insurer agrees to pay the policy holder a sum of money upon the occurrence of a specific event. In most cases, the policy holder pays part of the loss (called the deductible), and the insurer pays the rest. Examples include car insurance, health insurance, disability insurance, life insurance, and business insurance.

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Insurance > Health insurance

open formulary

Health care; Managed care

A list of drugs that a health plan prefers, but does not mandate physicians to prescribe.

compendium

Health care; Managed care

A list of information about drugs, their interactions, and their side effects.

nonplan provider

Health care; Managed care

A health care provider without a contract with an insurer; similar to a nonparticipating provider.

intermediate nursing facility

Health care; Managed care

A health facility licensed by the state and oft en certified by Medicare or Medicaid to provide intermediate care.

Medicare+Choice Medical Services Account

Health care; Managed care

A health insurance account created by contributions from the Centers for Medicare and Medicaid Services (CMS, formerly HCFA) to pay out-of-pocket medical expenses for Medicare ...

prospect file

Health care; Managed care

A health insurance agent’s card of computerized listing of present clients, prospects, and suspects, usually arranged according to alphabet and by date to contact.

first pass

Health care; Managed care

A health insurance claim that has been adjudicated from submission to payment or rejection.