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  2. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  3. Appellate procedure in the United States - Wikipedia

    en.wikipedia.org/wiki/Appellate_procedure_in_the...

    The appellate court cannot refuse to listen to the appeal. An appeal "by leave" or "permission" requires the appellant to obtain leave to appeal; in such a situation either or both of the lower court and the court may have the discretion to grant or refuse the appellant's demand to appeal the lower court's decision.

  4. List of United States courts of appeals cases - Wikipedia

    en.wikipedia.org/wiki/List_of_United_States...

    Every year, each of the thirteen United States courts of appeals decides hundreds of cases. Of those, a few are so important that they later become models for decisions of other circuits, and of the United States Supreme Court , while others are noted for being dramatically rejected by the Supreme Court on appeal.

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  6. Service of process - Wikipedia

    en.wikipedia.org/wiki/Service_of_process

    In the U.S. legal system, service of process is the procedure by which a party to a lawsuit gives an appropriate notice of initial legal action to another party (such as a defendant), court, or administrative body in an effort to exercise jurisdiction over that person so as to force that person to respond to the proceeding in a court, body, or other tribunal.

  7. Explanation of benefits - Wikipedia

    en.wikipedia.org/wiki/Explanation_of_benefits

    Generally, secondary insurance pays only the amount the EOB says the member is responsible for. Secondary EOBs show if the patient still has any responsibility to the provider. After the member's insurances have processed the claim, the provider bills the member for the remaining balance, if any. [4]

  8. Zeran v. America Online, Inc. - Wikipedia

    en.wikipedia.org/wiki/Zeran_v._America_Online,_Inc.

    Zeran v. America Online, Inc., 129 F.3d 327 (4th Cir. 1997), [2] is a case in which the United States Court of Appeals for the Fourth Circuit determined the immunity of Internet service providers for wrongs committed by their users under Section 230 of the Communications Decency Act.

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