U
U
Unbundling: Refers to separating out services or costs that may have been billed together. Administrators processing claims use industry standards and accepted coding practices to govern bundling and unbundling functions.
Underwriting: Refers to the review of prospective client or product to determine risks, pricing, and feasibility.
Uniform Billing Code of 1992 (UB-92): A revision of UB-82, a federal directive that requires hospitals follow prescribed billing practices like itemization of services. This directive was put into effect in 1993.
United States Per Capita Cost (USPCC): Projected Medicare payment based on average Medicare beneficiary in the subsequent year.
Upcoding: Used in association with claims submission whereby the claim is upgraded to a code higher in level than the code of the service that was provided to the insured.
Urgent Care: Type of care used to treat non-life-threatening illnesses or medical conditions that do not require treatment at a hospital emergency room.
Urgent Care Center: A medical facility that provides immediate, short-term healthcare treatment for urgent medical conditions that do not require more intensive treatment that would be available at a hospital emergency room.
Urgent Care Facility: A clinic that specialized in delivering urgent medical care.
Urgi-Center: See Urgent Care Center.
Usual, Customary and Reasonable (UCR): See Reasonable and Customary.
Utilization: Refers to the extent / frequency that a group obtains a medical service or a specific category of medical procedures over a specified time period.
Utilization Management (UM): The process of integrating case management and clinical reviews with other entities like providers, payers, patients, and employers.
Utilization Review (UR): Formal evaluation of medical efficiency and necessity of medical services.
Utilization Review Accreditation Commission (URAC): see American Accreditation Health Care Commissions