Definition. A medical condition that has been diagnosed or treated within a certain specified period of time just before the patients effective date of coverage. A Pre-existing condition may not be covered for a determined amount of time as defined in the insurance terms of coverage (typically 6 to 12 months).
You'll come across Pre-existing Condition (PEC) while working the revenue cycle — from eligibility and claim submission to payment posting and denials. See the related terms below, or browse the full glossary and the Knowledge Hub.