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Insurance

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Term
Definition
show Provided by a person's employer  
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Primary Insurance   show
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show the amount of money that a person pays for their insurance  
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show Double coverage (ex. your work and your parents'insurance.  
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show Individuals pay for their insurance. ( Usually for people who are self employed.  
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Self pay   show
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Government Plans   show
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Co-pay   show
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Deductibles   show
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Explanation of benefits (EOB)   show
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Co-insurance   show
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show An EOB sent to the provider from the insurance carrier. Is similar to the EOB, the RA contains multiple patients and providers .Also includes the electronic funds transfer information or a check for payment.  
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Advance beneficiary notice (ABN)   show
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Medicare   show
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show Authorizes dependents of military personnel to see civilian practitioners.  
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CHAMPVA   show
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Medicaid   show
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show A state legislative law that protects employees against the cost of medical care resulting from a work related a work- related injury.  
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CHIP   show
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show Offered through an individual's employer who will pay a portion of the premium and deduct the remainder of the premium from the employee's pay.  
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show Insurance plans that an individual funds themselves. Patients might pay the entire premium themselves if they are self- employed.  
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HMO (Health Maintenance Organization   show
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PPO (Preferred Provider Organization)   show
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show A savings account can be used to pay for medical expenses. These funds are not taxed until the time of withdrawal. Any amount not used stays in the account and accrues interest after a year. This must be used in conjunction with a high deductible plan. Co  
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show This account is funded with the pretax dollars by an employee. Do not roll over to the next year ( funds will be lost if not used).  
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show international classification of diseases. October 1sr 2015. 55,000 more codes than the old system. Specific reporting of diseases. 3-7 characters. first character is a letter, second and third are numbers.  
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show translates written descriptions of diseases, ailments, injuries or any health encounter into a numeric or alphanumeric code.  
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show can be submitted electronically, must be timely (12 months) must use an X. medicare only accepts capital letters.  
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show form required by insurance companies that is used when a provider wants to send a pt to a specialist.  
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show This means that the provider and insurance company have agreed between the amounts charged and approved and what will and will not be reimbursed. * Non-participating provider may claims all together or pay at a lower reimbursement rate.  
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Account balance   show
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show an amount owed.  
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show money owed to the provider  
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show debts incurred and not paid yet  
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Credit   show
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show the entire saleable property of a person, association, cooperation, or estate applicable/subject to the payment of debts.  
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Liabilities   show
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Electronic Medical Record (EMR)/Electronic Health Record (HER)   show
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