Health Insurance Glossary
- Rating Process:
- The process by which a premium or rate for a group is determined. Items that may be considered in the rating process include age, sex, type of industry, benefits and administrative costs.
- Reasonable and Customary Charges:
- -see Usual, Customary and Reasonable (UCR) Charge.
- Referral:
- The process through which a patient under a managed care health insurance plan is authorized by his or her primary care physician to a see a specialist for the diagnosis or treatment of a specific condition.
- Registered Nurse (RN):
- A licensed professional nurse with a four-year nursing degree, trained to provide all levels of nursing care including the administration of medication.
- Renewal:
- Renewal occurs when a member continues coverage under a health insurance plan beyond the original time frame of the contract. At the end of each benefit year, a plan member is generally invited to renew his or her coverage.
- Renewal Date:
- The date on which a member's health insurance plan benefit year renews.
- Respite Care:
- Normally associated with hospice care, respite care is a benefit often made available for family members of a patient, providing the patient's primary caretaker with a break or respite from caring for the patient. Respite care may be provided for the patient in either the home or a nursing home setting.
- Rider:
- An amendment or modification to an insurance contract. See also, Benefit Riders.
please note, however, that definitions of certain terms may vary across insurance companies.
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