Health Insurance Glossary
- Underwriting:
- The process by which an insurer determines whether it will accept an application for insurance based upon risks and projections, and through which a determination on monthly premium is made.
- Uniform Billing Code of 1992 (UB-92):
- The Uniform Billing Code of 1992 set industry-wide standards for medical billing practices.
- Usual, Customary and Reasonable (UCR) Charge:
- This refers to the standard or most common charge for a particular medical service when rendered in a particular geographic area. It is often employed in determining Medicare payment amounts.
- Utilization:
- This term refers to how frequently a group uses the benefits associated with a particular health insurance plan or healthcare program.
- Utilization Management/Review:
- This term is often used to describe a group (or the work performed by a group) of nurses and doctors who work with health insurance plans to determine if a patient's use of healthcare services was medically necessary, appropriate, and within the guidelines of standard medical practice. Utilization Management/Review may also be referred to as Medical Review.
please note, however, that definitions of certain terms may vary across insurance companies.
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