Glossary of Insurance Related Terms

Unallocated Benefit

A benefit providing reimbursement of expenses up to a maximum but without any schedule of benefits as such. (H)

Unemployment Compensation Disability Insurance (UCD)

Health Insurance that covers off-the-job accidents and sickness. It does not cover disability resulting from an injury or sickness covered by Workers Compensation Insurance. See also Disability Benefits Law. (H)

Uniform Billing Code of 1992 (UB-92)

This code is scheduled to be implemented on October 1, 1993. It's a federal directive which states how a hospital must provide their patients with bills, itemizing all services included and billed on each invoice. (H)

Uniform Premium

A rating system that is used to calculate premiums for all insureds with no distinctions as to age, sex or occupation. (LI,H)

Uniform Provisions

A set of provisions regarding the operating conditions of individual Health policies developed in a model law recommended by the National Association of Insurance Commissioners and required, with minor variations by almost all jurisdictions, and permitted in all jurisdictions. (H)

Urgi-Center

An emergency medical service center which is separate from any other hospital or medical facility. (H)

Usual, Customary and Reasonable Charges

The price for medical services the insurance company determines to be the average charge for similar procedures in a given geographical location.

Utilization

This refers to how much a covered group uses a particular health plan or program. (H)

Utilization and Review Committee

A committee composed of medical personnel whose purpose it is to monitor the health care services and supplies provided to Medicare patients. (H)

Utilization Management

This procedure or process utilizes a review coordinator to evaluate the necessity and appropriateness of various health care services. (H)

Utilization Review

A cost control mechanism by which the appropriateness, necessity, and quality of health care is monitored by both insurers and employers. (H)