Mindblown: a blog about philosophy.

Review of claims by governments, medical foundations, PAROs, insures or other responsible for payment to determine liability and amount of payment. This review may include determination of the eligibility of the claimant or beneficiary; of the eligibility of the provider of the benefit; that the benefit for which payment is claimed is covered; that the…

A form of malpractice insurance gaining increasing popularity among insurers because it increases the accuracy of ratemaking. In this type of policy the insured is covered for any claim made, rather than injury occurring, while the policy is in force. Claims made after the insurance lapses are not covered as they are by a claims…

The conventional form of malpractice insurance, under which the insured is covered for any claims arising from an incident which occurred or is alleged to have occurred during the policy period, regardless of when the claim is made. the only limiting factors are the statutes if limitations, which vary from State to State. An alternative…

A request to an insurer by an insured person (or, on his behalf, by the provider of a service or good) for payment of benefits under an insurance policy.  

A program, administered by the Department of Defense for the Veterans Administration, without premium but with cost-sharing provisions, which pays for health care provided by civilian providers to dependents of totally disabled veterans who are eligible for retirement pay from a uniformed service. The federal program, administered by the Defense Department for the Veterans Administration,…

A program, administered by the Department of Defense, without premium but with cost-sharing provisions, which pays for care delivered by civilian health providers to retired members, and dependents of active and retired members, of the seven uniformed services of the United States (Army, Navy, Air Force, Marine Corps, Commissioned Cori)s of the Public Health Service,…

Drug products from different sources which contain essentially identical amounts of the identical active ingredients in identical dosage forms, meet existing physiochemical standards in official compendia, and are therefore chemically indistinguishable.  

In malpractice, a doctrine in use in a decreasing number of States that nonprofit, or charitable, hospitals and other health facilities are not subject to suit for malpractice. The doctrine of charitable immunity relies on and involves: waiver of the patient’s right to sue for negligence by accepting the charity; the basic unfairness, either assumed…

Prices assigned to units of medical service, such as a visit to a physician or a day in a hospital. Charges for services may not be related to the actual costs of providing the services. Further, the methods by which charges are related to costs vary substantially from service to service and institution to institution.…