adjusted claim

ad·just·ed claim

(ă-jŭstĕd klām)
Additional payment to a health care provider based on modification of claim reimbursement.
References in periodicals archive ?
1] All net income, earnings per share, adjusted EBITDA, adjusted EBITDA per adjusted claim, adjusted net income and adjusted earnings per share amounts are presented as attributable to Express Scripts, excluding non-controlling interest representing the share allocated to members of our consolidated affiliates.
When an adjustment resulted in a greater expense, auditors said, the state often sought reimbursement at the temporarily higher percentage for the entire adjusted claim, when that higher rate should only have applied to the increased amount over the original claim.
Working with Wolters Kluwer Financial Services, we can create an accurate record of the policies and procedures relied upon by our claims adjusters, enhance claims procedures with rich compliance information, and easily maintain an audit trail of the considerations that were made regarding each adjusted claim.
We define EBITDA per adjusted claim as EBITDA divided by adjusted pharmacy claims.
Adjusted EBITDA from continuing operations per adjusted claim is a supplemental measurement used by analysts and investors to help evaluate overall operating performance.
2) Excluding the impact of RxAmerica, Maintenance Choice[TM], and an increase in litigation reserves, EBITDA per adjusted claim would have been $3.
Accordingly, the Company is unable to include these charges in the list of GAAP items not included in guidance for 2014 full-year and third quarter adjusted EPS, adjusted selling, general and administrative, adjusted EBITDA and adjusted EBITDA per adjusted claim or to provide a reconciliation to the corresponding GAAP measure.
Partially offsetting the expected decrease in claims is an increase in guidance for adjusted EBITDA per adjusted claim to a range of $5.
Excluding UNH from both periods, adjusted EBITDA from continuing operations attributable to Express Scripts per adjusted claim increased 11% from the fourth quarter of 2012 - See Table 7.
Adjusted gross profit per adjusted claim was a record $3.
2 million in 2005, while gross profit per adjusted claim increased 35 percent to $2.
Gross profit margin and EBITDA per adjusted claim increases over last year are mainly attributed to improved operating performance, increased generic utilization and the realization of synergies.