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Medical Coding

Chapter 1

Benefits The amount of money a health plan pays for services covered in an insurance policy.
Capitation Payment method in which a prepayment covers the provider's services to a plan memeber for a specified period of time.
Centers for Medicare and Medicaid Services (CMS) Federal agency within the department of Health and Human Services that runs Medicare, Medicaid, Clinical Laboratories (under the CLIA program) and other governmental health programs.
Coinsurance The portion of charges that an insured person must pay for health care services after payment of the deductible amount; usually sated as a percentage.
Consumer-Driven Health Plan Type of employment-sponsored medical insurance that combines a high deductible plan with a medical savings plan that covers some out-of-pocket expenses.
Copayment an amount that a health plan requires a beneficiary to pay at the time of services for each health care encounter.
Credentialing The process of periodic verification that a provider or facitlity meets the professional standards of a certifying organization. Physician credentialing involves screening and evaluating qualifications and other credentials, including licensure, required
Created by: Alicia2477