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25 Cards in this Set
- Front
- Back
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Another name for commerial insurance
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private health insurance
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What is hospitalization insurance
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insurance that pays all or part of patients hospital expense
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Mayjor medical coverage is effective when
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initial policy has reached its limit
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waiting period for disability benefits
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2 weeks
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CPT codes
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Current procedural terminology
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ICD-9-cm
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international classification of diseases-9th edition=clinical modification
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HCFA-1500
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health care financing administration
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pts written authorization giving insurance company right to pay the dr for billed charges
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assingment of benefits
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period of time which payments for medicare inpatient hospital benefits are available
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benefit period
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written and documented request for reimbursement of a eligible expense under a insurance plan
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claim
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transferring narrative description of a disease and procedures into a number
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coding
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cost sharing provision requires the insured to assume a portion of the cost of covered services
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coinsurance
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amount pt must pay before plan pays
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copayment
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pt is eligible for both medicare and medicaid
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crossover claim
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amount pt must pay each year before plan pays
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deductible
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lists of determined amounts to be paid for specific services by the insurance carrier on behalf of the insured
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indemnity schedule
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individual who is covered under an insurance plan
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insured
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person without insurance coverage or funds
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medically indigent
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provider not accept allowable charge as full fee
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nonparticipating provider
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obtain prior approval for surgery and other procedures to be reimbursed
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preauthorization
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amount paid for insurance coverage
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premium
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negotiated fee for service or capitalized basis agreed
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prepaid plan
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written exception to a insurance contract,expanding,increasing, or modifying coverage of policy
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rider
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person who holds a health benefit plan/contract
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subscriber
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provides protection against risk,loss or ruin by contract
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insurance
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