We challenged a big insurer--and won. 1995

G R Gibson

UI MeSH Term Description Entries
D007345 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. Claims Review,Insurance Audit,Insurance Claims Processing,Analysis, Claims,Claim Review, Insurance,Claims Analysis,Insurance Claims Analysis,Review, Claims,Review, Insurance Claim,Analyses, Claims,Analyses, Insurance Claims,Analysis, Insurance Claims,Audit, Insurance,Audits, Insurance,Claim Reviews, Insurance,Claims Analyses,Claims Analyses, Insurance,Claims Analysis, Insurance,Claims Processing, Insurance,Claims Reviews,Insurance Audits,Insurance Claim Reviews,Insurance Claims Analyses,Processing, Insurance Claims,Reviews, Claims,Reviews, Insurance Claim
D007357 Insurance, Physician Services Insurance providing benefits for the costs of care by a physician which can be comprehensive or limited to surgical expenses or for care provided only in the hospital. It is frequently called "regular medical expense" or "surgical expense". Physician Services, Insurance,Services Insurance, Physician,Insurance Physician Service,Insurance Physician Services,Insurances, Physician Services,Physician Service, Insurance,Physician Services Insurance,Physician Services Insurances,Service, Insurance Physician,Services Insurances, Physician,Services, Insurance Physician
D009820 Ohio State bounded on the north by Michigan and Lake Erie, on the east by Ohio River and Pennsylvania, on the south by Ohio River, and on the west by Indiana.
D012017 Referral and Consultation The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide. Consultation,Gatekeepers, Health Service,Hospital Referral,Second Opinion,Consultation and Referral,Health Service Gatekeepers,Hospital Referrals,Referral,Referral, Hospital,Referrals, Hospital,Consultations,Gatekeeper, Health Service,Health Service Gatekeeper,Opinion, Second,Opinions, Second,Referrals,Second Opinions
D003952 Diagnostic Imaging Any visual display of structural or functional patterns of organs or tissues for diagnostic evaluation. It includes measuring physiologic and metabolic responses to physical and chemical stimuli, as well as ultramicroscopy. Imaging, Diagnostic,Imaging, Medical,Medical Imaging
D005568 Forms and Records Control A management function in which standards and guidelines are developed for the development, maintenance, and handling of forms and records. Records Control,Forms Control,Records Management,Controls, Records,Management, Records,Records Controls

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