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Chapter 3 Insurance;

Chapter 3 Insurance.

Exclusion Provisions written into contract denying coverage or limiting the scope of coverage
Waiting Period Period of time where insurance is not in effect or that certain diagnosis may not be covered.
Medicare People that are older than 65. Sponsored by the federal government.
Medicaid Sponsored by the federal, state and local governments. Provides health care to people on welfare, disabled.
Reimbursement Cycle The process from start to finish used to collect money in the physician office.
Balance Amount owed on a debit transaction;
Patient Registration Form Used to collect personal data and essential facts about their insurance.
Encounter Form An all-encompassing billing form personalized to the practice of the physician. Used when patient submits an insurance billing.
Assignment A transfer, after an event insured against, or an individual's legal right to collect an amount payable under an insurance contract.
CHAMPVA Federal program that covers medical expenses of spouses and children of veterans with total, permanent, service connected disabilities.
TRICARE a government sponsored program that provides hospital and medical services for dependents of active or retired service personnel.
Unemployment Compensation Disability Insurance Covers off the job injury or sickness that is paid by the deductions from a person's paycheck.
(RA) Remittance Advice Describes services billed and how payment was determined. Used by Medicare/Medicaid.
Provider physician or organization that has a contractual agreement with an insurance plan.
Day Sheet A register for recording daily business transactions.
Accounts Receivable The total amount of money owed for professional services rendered.
(EOB) Explanation of Benefits Gives an explanation of services billed and includes a breakdown of how the payment was determined.
Created by: kmariemurray