Work Def Flashcards
What is COINSURANCE
percentage of costs you pay after you’ve met your deductible
What is CO-PAYMENT
A predetermined rate you pay for services at the time of service
What is a DEDUCTIBLE
the amount you pay to your healthcare before insurance begins to pay.
What is COB ( coordination of benefits)
When two insurance plans work together to pay for claims for the same person
What is an EXPLANATION OF BENEFITS
A statement from insurance company sent to a member listing services that were billed by your provider and how those charges were processed
What is an HSA
A tax advantaged savings account to be used in conjunction with certain high deductible insurance plans to pay for qualifying medical expenses
What is a VISIT LIMIT
A set number by insurance policies that tells the patient and provider how many billable visits are allowed. Everything after will be patient’s responsibility.
Medicare
Federally administered health insurance program for most people over the age of 65 and certain eligible individuals
Medicaid
A state funded healthcare for low income and disabled
What is ACTIVE CARE
It is specific treatment plan put in place by the provider. Typically more frequent in the beginning or care. Never exceed a 2 week gap
What is MAINTENANCE CARE
Care that follows active care after the patients health status has become stable. Maintains the improvement that was achieved during active care. Typically exceeds 2 week gaps between visits
What is MEDICALLY NECESSITY
It’s a term used by insurance to define what services are covered by insurance companies and what is not.
They only cover what they deem is medically necessary
BCBS Deductible 1-2 regions
$28.15
BCBS Deductible 3-4 Regions
$40.31
BCBS Deductible 5 regions
$52.82
