The charge for keeping the insurance policy in effect
What is premium
100
A payment structure in which health maintenance organization prepays an annual set fee per patient to a physician
What is capitation
100
Pays for inpatient expenses up to 90 days, medical care at home and psychiatric hospitalization
What is Medicare Part A
200
Explanation of benefits
What is EOB
200
A Health benefit program designed for low-income, blind, or disabled patients: needy families
What is Medicaid
200
Payments form the health plan for medical services are also called
What is benefits
200
The maximum amount the payer will pay any provider
What is allowed charge
200
Medicare Advantage Plans
What is Medicare Part C
300
Health Maintenance Organization
What is HMO
300
This part of Medicare covers a portion (usually 80%) of the allowed charges for a wide range of outpatient procedures and supplies
What is Medicare Part B
300
A fixed dollar amount that must be paid by the insured for charges of providers, or "met" once a year, in addition to the premium
What is deductible
300
The process of the provider contacting the insurance plan to see if the proposed procedure is a covered service under the patient's insurance plan
What is Preauthorization
300
Insurance that provides a monthly, prearranged payment to an individual who cannot work as the result of an injury or disability
What is Disability insurance
400
Remittance Advice
What is RA
400
This is the prescription plan for Medicare
What is Medicare Part D
400
A fixed percentage of covered charges after the deductible is met
What is coinsurance
400
The oldest and most expensive type of policy, this repays policyholders for healthcare costs due to illness and accidents
What is Fee-for-Service
400
Private Commercial Insurance Carriers
What is Cigna, Aetna, Travelers
500
Explanation of payment
What is EOP
500
This is the Medicare hospital benefit
What is Medicare A
500
A fixed fee collected at the time of the visit
What is copayment
500
This is not a health insurance plan but it is a healthcare benefit for families of uniformed personnel and retirees from the uniformed services, including the Army, Navy, etc.