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Health Insurance Glossary

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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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