Insurance Terms
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| Private Insurance | show 🗑
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| show | insurance that is filed first and is the main insurance for a person
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| show | amount of money that a person pays for their insurance
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| Secondary Insurance | show 🗑
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| Self Insured | show 🗑
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| Self Pay | show 🗑
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| show | special programs by state and federal government that provides insurance
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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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| Remittance Advice (RA) | show 🗑
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| show | form that Medicare pts will sign when the provider thinks Medicare won't pay for a specific service/ item
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| show | pts 65+ for Part A (hospitalization), Part B (routine office visits), Part D (prescription coverage)
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| show | authorities dependents of military personnel to see civilian practitioners
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| CHAMPVA | show 🗑
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| show | health insurance to the medically indigent population through a cost sharing program between federal government and states
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| show | state legislative law that protects employees against the cost of medical care resulting from a work-related injury
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| show | offers low-cost health coverage for children birth-18; designed for families who earn too much money for Medicaid, but cannot afford to buy private health coverage
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| show | offered through an individual's employer who will usually pay a portion of the premium and then deduct the remainder of the premium from the employee's pay
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| show | insurance plans that an individual funds themselves; pts might pay the entire premium themselves if they are self-employed
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| show | health insurance plan that usually limits coverage of care from doctors who work fo/ contract with the HMO; generally won't cover out-of-network care except in an emergency; may require you to live/ work in its service area to be eligible for coverage
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| Preferred Provider Organization (PPO) | show 🗑
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| Health Savings Account (HSA) | show 🗑
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| Flexible Spending Account (FSA) | show 🗑
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| show | international classification of diseases; allows for specificity and laterality of coding for payment
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| Upcoding | show 🗑
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| CMS-1500 | show 🗑
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| Referrals | show 🗑
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| show | provider and insurance company have agreed between the amounts charged and approved and what will/will not be reimbursed
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| Account Balance | show 🗑
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| Debit | show 🗑
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| Account Receivable | show 🗑
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| show | debts incurred and not yet paid
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| Credit | show 🗑
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| show | entire saleable property of a person, association, corporation, or estate applicable or subject to the payment of debts
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| show | amounts owed; debt
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| Electronic Medical Record (EMR) | show 🗑
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| show | EMR+ other info to be used between facilities
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