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GLOSSARY
Parol evidence rule - states that a contract may not be altered without written consent of both parties (applies to written portion of contract.)
Participating Physician - a doctor or supplier who agrees to accept Medicare assignment on all claims under the Medicare program
Participating policies (par) - insurance that pays dividends to policyholders.
Participation - agreement by which doctors accept the insurance carrier's usual, customary, and reasonable amount as payment in full.
Peer Review Organization - an organization in which practicing physicians assume responsibility for reviewing the propriety and quality of healthcare services provided under Medicare and Medicaid.
Persistency - the staying quality of insurance policies (renewals).
Physician's Expense Insurance - coverage that provides benefits toward the cost of such services as doctor's fees for nonsurgical care in the hospital, at home, or in a physician office, and X-rays or laboratory tests performed outside of the hospital.
Policy - the written instrument, in which a contract of insurance is set forth.
Policy fee - a flat amount added to premium to pay expenses. In some instances it is charged each time the premium is paid and in others, it is one time paid with the initial premium.
Policy owner - the person who has the right to exercise the rights and privileges in the policy. This person may or may not be the insured.
Policy Term - the period for which an insurance policy provides coverage.
Policyholder - the person who has possession of the policy, usually the insured.
PPO - see Preferred Provider Organization.
Preexisting Condition - a health problem existed prior to a person became insured; policies with preexisting condition limitations will not pay benefits for these prior health problems until a specified time period (for example six months to a year) has elapsed.
Preferred Provider Organization - a group of physicians and/or hospitals that provides services at reduced costs to employers or health insurers.
Premium - a payment or periodic payments made by the insured/owner to the insurer to keep an insurance policy in effect.
Private insurance - insurance furnished by non-governmental insuring organizations.
Pro-rata cancellation - adjusting the premium charge in proportion to the exact coverage that has been in force.
Producer - insurance agent or broker.
Provider - the party that gives a medical service - a doctor, an ambulance company, or a hospital.
Pure protection - insurance whereby premiums are paid for protection in the event of death or disability. There is no cash value in the policy.
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