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ALH 151
week2
| Question | Answer |
|---|---|
| Authorization | an approved referral |
| beneficiary | individual entitled to receive benefits |
| benefits | amount payable by an insurance company to an individual or company |
| capitation | fixed payment method used in managed care to reimburse provider for patient enrollment |
| TRICARE | insurance for active duty military and their families |
| CHAMPVA | civilian health and medical program of the veterans administration |
| co-insurance | policyholder and insurance company share cost of coverage |
| copayment | money that is paid at the time of service by patient |
| dependents | other individuals designated by the insurance covered under the insurance policy |
| eligibility | describes whether a patient is entitled to coverage for a service |
| EOB | explanation of benefits |
| guarantor | person responsible for paying medical bill |
| insured | persons covered by insurance |
| HMO | Health Maintenance Organization |
| Medicare | insurance for disabled or elderly |
| medicaid | insurance for people without funds |
| policy holder | person who carries insurance |
| premium | amount paid for the insurance by policy holder |
| referral | insurance term used when PCP wants to send patient to another physician |
| preauthorization | obtaining permission before service is rendered |
Created by:
kristy.marsh
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