Our online medical glossary of medical terms and definitions includes definitions for terms related to treatment, and general medicine
INSURANCE CLAIM REVIEW
Review of claims by insurance companies to determine liability and amount of payment for different services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under other policy; or determination that the service was necessary and of reasonable price and characteristic.