- Industry: Health care
- Number of terms: 3360
- Number of blossaries: 0
- Company Profile:
CIGNA Corporation, headquartered in Philadelphia, provides health care and related benefits in the United States and internationally.
A film of sticky material containing saliva, food particles, and bacteria that attaches to the tooth surface both above and below the gum line. When left on the tooth it can promote gum disease and tooth decay.
Industry:Health care
A health plan allowing the member to choose to receive a service from a participating or non-participating provider, with different benefits levels associated with the use of participating providers.
Industry:Health care
The process through which the reviewer evaluates the attending physician's request for admission to an acute care hospital and length of stay. Medical necessity is determined using established criteria. If PAC/CSR is part of the health benefit plan, the admission or continued stay must be certified for full payment of a claim.
Industry:Health care
The process of obtaining certification from the health plan for routine hospital stays or outpatient procedures. The process involves reviewing criteria for benefit coverage determination.
Industry:Health care
This is the amount of an employee's wages or salary that was in effect and covered by the plan on the day before the disability began.
Industry:Health care
A health condition (other than a pregnancy) or medical problem that was diagnosed or treated before enrollment in a new health plan or insurance policy.
Industry:Health care
When an employee has a physical or mental condition that existed prior to the effective date of his or her insurance coverage, it is considered a pre-existing condition. Most plans exclude or decrease disability benefits for an illness or injury for which an employee received medical treatment or consultation within a specified time period before becoming covered under the plan. The limitation generally expires after coverage has been in effect for a specified period of time.
Industry:Health care
A specific type of CIGNA health plan with a national network of physicians. Plan members can visit physicians both in and out of the network, and can visit specialists without a referral. Members don't need to choose a primary care physician for coverage. An annual deductible is required, and an out-of-pocket maximum applies.
Industry:Health care
