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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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show A specified sum of money based on the patient's insurance policy benefits due at the time of service.  
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show A specific amount of money a patient must pay out of pocket before the insurance carrier begins paying for services. Deductible amounts are usually on a calendar year accrual basis.  
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show Provided to the patient by the insurance company as a statement that details what services were paid, denied, or reduced in payment. An EOB also includes information that pertains to the amounts applied to the deductible, coinsurance or other allowed amou  
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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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show A form that a Medicare patient will sign when the provider thinks Medicare won't pay for a specific service or item.  
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show Patients 65 or older for Part A ( hospitalization) Part B (routine office visits) , Part D ( prescription coverage).  
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Tricare   show
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CHAMPVA   show
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Medicaid   show
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Worker’s Compensation   show
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CHIP   show
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Group Policies   show
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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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show A type of health insurance plan that usually limits coverage of care from doctors who work for or contract with the HMO. It generally won't cover out of network care except in an emergency. An HMO may require you to live or work in its service area to be  
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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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Flexible Spending Account (FSA)   show
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ICD-10-CM   show
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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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CMS-1500 form   show
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Referrals   show
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Participating Provider   show
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show total amount owed on an account  
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show an amount owed.  
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Accounts receivable   show
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show debts incurred and not paid yet  
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show a monetary balance in an individuals favor  
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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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show amounts owed- debt  
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Electronic Medical Record (EMR)/Electronic Health Record (HER)   show
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