insurance terms
what is out of pocket
patients money
DAW 1
prescriber request
Who is disability for
Those who can't return to work temporarily or permanently
profession liability
coverage professionals from claims or financial caused by an error or negligent
DAW 0
default no selection
What is positive formulate
Formulates that are covered by insurance
DAW 2
patient request
workers compensation
employees injuries on the job
Managed indemnity
Certain service require approval
patient pay for service provided
allow PCP to participate in their plan
DAW 3
pharmacist dispense
What is drug utilization review
to monitor patterns of prescribing, dispensing, and dosing
DAW 4
generic not in stock
Who is medicaid for
income needs
Traditional indemnity
can chose physician without referral
patients pay provider for each service provided
DAW 5
brand dispensed as generic
name 1 thing about deductible
require patients to spend a certain amount out of pocket
out of pocket pay before insurance pay
DAW 7
brand mandated by law
Who is Medicare for
Adults 65 and older and disabilities
What is PPO
Covers in-network and out of network
allow you to see specialist without referral
DAW 6
request by insurance
name 2 thing about reimbursement?
patients must submit a receipt
patients pay out of pocket
covers the policy holder medical expenses
patient must submit a claim
DAW 9
others, contact national council for prescription drug program
Who is tricare for
service member and retirees
What is a HMO
Limits patients to in-network providers only
cost effective
DAW 8
generic not available in market place