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Insurance Claim Review
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Definition of 'Insurance Claim Review'

Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.

Common names: Insurance Claim Review; Review, Insurance Claim; Claims Review; Claims Analysis; Review, Claims; Claims Reviews; Reviews, Claims; Claim Review, Insurance; Claim Reviews, Insurance; Insurance Claim Reviews; Reviews, Insurance Claim; Analysis, Claims; Analyses, Claims; Claims Analyses

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Sunday, November 08, 2009

Revised medical criteria for evaluating malignant neoplastic diseases. Final rule.

4 Oct 2009 We are revising some of the criteria in the Listing of Impairments (the listings) that we use to evaluate claims involving malignant neoplastic diseases (cancer) under titles II and XVI of the Social Security Act (Act). The revisions reflect our ... Read more...


Universal health insurance and equity in primary care and specialist office visits: a population-based study.

30 Aug 2009 PURPOSE: Universal coverage of physician services should serve to reduce socioeconomic disparities in care, but the degree to which a reduction occurs is unclear. We examined equity in use of physician services in Ontario, Canada, after controlling ... Read more...


Perioperative peripheral nerve injuries: a retrospective study of 380,680 cases during a 10-year period at a single institution.

30 Aug 2009 BACKGROUND: Peripheral nerve injuries represent a notable source of anesthetic complications and can be debilitating. The objective of this study was to identify associations with peripheral nerve injury in a broad surgical population cared for in ... Read more...

 

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Technical information about 'Insurance Claim Review'

Definition: Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.

Descriptor UI: D007345

Alternative terms: Insurance Claim Review; Review, Insurance Claim; Claims Review; Claims Analysis; Review, Claims; Claims Reviews; Reviews, Claims; Claim Review, Insurance; Claim Reviews, Insurance; Insurance Claim Reviews; Reviews, Insurance Claim; Analysis, Claims; Analyses, Claims; Claims Analyses; Insurance Audit; Audit, Insurance; Audits, Insurance; Insurance Audits; Insurance Claims Processing; Claims Processing, Insurance; Processing, Insurance Claims;

Allowable Qualifiers: classification; economics; history; legislation & jurisprudence; organization & administration; standards; trends; utilization; statistics & numerical data; ethics;

Tree Number: N03.219.521.576.215;

History Note: 91(86); was see under INSURANCE, HEALTH 1986-90

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