CBCS: Module 2 Vocab
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| Capitation | An agreement with a provider to receive a pre-established payment for health care services to enrollees over a period of time
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| Coinsurance | An agreement with a provider to receive a pre-established payment for health care services to enrollees over a period of time
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| Copayment (copay) | Flat, fixed amount that a patient pays for specific services (ex. office or emergency department encounters)
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| Covered Benefits | Services outlined in the policy that are payable by the health plan
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| Deductible | Annual amount the patient must pay before the insurance will begin to pay for covered benefits
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| Guarantor | The individual who is responsible for paying any patient responsibility after the insurance has processed a claim
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| Health Maintenance Organization | A group of contracted providers that agree to the payment contract for its members
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| In-Network (INN) | A provider who has signed an agreement with the insurance plan
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| Noncovered Services | Services that are not payable by the health plan
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| Out-of-Network (ONN) | A provider who does not have a signed agreement with an insurance plan
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| Policyholder | The individual who signs a contract with a health insurance company
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| Preferred Provider Organization (PPO) | A type of managed care organization where providers join network and are considered preferred when a patient seeks treatment
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| Premium | The amount a patient pays each month to receive benefits
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| HMO | Health Maintenance Organization
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| PPO | Preferred Provider Organization
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| CMS | Centers for Medicare/Medicaid Services
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| COB | Coordination of Benefits
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| CPT | Current Procedural Technologies
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| WC | Workers Compensation
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| ABN | Assignment of Benefits
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| HCPCS | Health Care Procedural Coding Services
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| DME | Durable Medical Equipment
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