TERMS
ACRONYMS
TERMS Cont.
ACRONYMS Cont.
Even More....!
100
A form of medical cost sharing in a health insurance plan that requires an insured person to pay a stated percentage of medical expenses after the deductible (if any) was paid.
What is coinsurance
100
BCBS
What is Blue Cross Blue Shield
100
The maximum amount of money the insurance company will authorize and pay for medical and other services furnished in an inpatient or outpatient setting.
What is an Allowable Charge.
100
DME
What is "Durable Medical Equipment"
100
NPI
What is "National Provider Identifier"
200
The amount of money the insured pays before the insurer (company) pays any part of the claim.
What is a deductible.
200
PPO
What is a "preferred provider organization"
200
The amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly, or annually.
What is a "premium"
200
CHIP
What is "Children's Health Insurance Program"
200
PCP
What is "Primary Care Provider"
300
A form of medical cost-sharing in a health insurance plan that requires an insured person to pay a fixed dollar amount when a medical service is received. The insurer is responsible for the rest of the reimbursement.
What is a copayment.
300
HMO
What is a Health Management Organization
300
A physician who focuses on a specific area of medicine or group of patients to diagnose, manage, prevent, or treat certain types of symptoms and conditions.
What is a "specialist"
300
EOI
What is "Evidence of Insurability"
300
POS
What is "Point of Service"
400
Accounts offered and administered by employers that provide a way for employees to set aside, out of their paycheck, pre-tax dollars to pay for the employee’s share of insurance premiums or medical expenses not covered by the employer’s health plan.
What is a flexible spending account.
400
FSA
What is Flexible Savings Account
400
The amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service. Sometimes used to determine the allowed amount.
What is "Usual, Customary, and Reasonable" or "UCR"
400
HIPAA
What is "Health Insurance Portability and Accountability"
400
UP CBO
What is "University Physicians Central Billing Office"
500
an agreement that designates the insurance company to pay the provider directly for health care services.
What is an Assignment of Benefits
500
PFFS
What is "patient fee for service"
500
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. A health insurance plan may require this for certain types of services before you receive them, except in an emergency.
What is "Pre-authorization"
500
MRN
What is "Medical Record Number"
500
UMVS
What is "UnitedHealth & Veterans Services"
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