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U . . .

Uniform Bill 1992 (UB-92)
Bill form used to submit hospital insurance claims for payment by third parties. Similar to HCFA 1500, but reserved for the inpatient component of health services.

Underwriting
One of the following:

  • The insurance function bearing the risk of adverse price fluctuations during a particular period.
  • Analysis of a group that is done to determine rates or to determine whether the group should be offered coverage at all. A related definition refers to health screening of each individual applicant for insurance and refusing to provide coverage for pre-existing conditions.

Urgent Services
Benefits covered in an Evidence of Coverage that are required in order to prevent serious deterioration of an insured's health that results from an unforeseen illness or injury.

Usual, Customary, and Reasonable (UCR)
Health insurance plans that pay a physician's full charge if it is reasonable and does not exceed his or her usual charges and the amount customarily charged for the service by other physicians in the area.

Utilization
Use of services. Utilization is commonly examined in terms of patterns or rates of use of a single service or type of service such as hospital care, physician visits, prescription drugs. Measurement of utilization of all medical services in combination is usually done in terms of dollar expenditures. Use is expressed in rates per unit of population at risk for a given period such as the number of admissions to the hospital per 1,000 persons over age 65 per year, or the number of visits to a physician per person per year for an annual physical.

Utilization Review (UR)
Also known as utilization management or utilization control, utilization review is a systematic means for reviewing and controlling patients' use of medical care services as well as the appropriateness and quality of that care. Usually involves data collection, review and/or authorization, especially for services such as specialist referrals, emergency room use, and hospitalization.


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