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In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person's health insurance went into effect. Before 2014, some insurance policies would not cover expenses due to pre-existing conditions.
While public health insurance contributions are based on the individual's income, private health insurance contributions are based on the individual's age and health condition. [ 28 ] [ 32 ] Reimbursement is on a fee-for-service basis, but the number of physicians allowed to accept Statutory Health Insurance in a given locale is regulated by ...
Medical underwriting is a health insurance term referring to the use of medical or health information in the evaluation of an applicant for coverage, typically for life or health insurance. As part of the underwriting process, an individual's health information may be used in making two decisions: whether to offer or deny coverage and what ...
In addition to medical expense insurance, "health insurance" may also refer to insurance covering disability or long-term nursing or custodial care needs. Different health insurance provides different levels of financial protection and the scope of coverage can vary widely, with more than 40% of insured individuals reporting that their plans do ...
A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [2] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4]
Critical illness insurance, otherwise known as critical illness cover or a dread disease policy, is an insurance product in which the insurer is contracted to typically make a lump sum cash payment if the policyholder is diagnosed with one of the specific illnesses on a predetermined list as part of an insurance policy.
This is an accepted version of this page This is the latest accepted revision, reviewed on 24 December 2024. Equitable transfer of the risk of a loss, from one entity to another in exchange for payment "Insure" redirects here. Not to be confused with Ensure. For other uses, see Insurance (disambiguation). An advertisement for a fire insurance company Norwich Union, showing the amount of assets ...
Some health insurance policies also define a medical condition as any illness, injury, or disease except for psychiatric illnesses. [16] As it is more value-neutral than terms like disease, the term medical condition is sometimes preferred by people with health