Insurance Term
Copayment
Requires the policy holder or patient to pay a specified dollar amount for each visit
Policyholder
A person who signs a contract with a health insurance company.
Gatekeeper
Primary Care Provider
Gag clause
Prevents providers from discussing all treatment options with patients.
Clearinghouse
Performs centralized claims processing for providers.
Capitation
Provider accepts payments for providing health care services to enrollees over a period of time.
Continuity of Care
Documents patient care services so that others who treat the patient have a source of information on to base additional care and treatment.
Accreditation
Voluntary process that a health care facility or organization undergoes to demonstrate that it has meet standards beyond those required by law.
Electronic transaction standards
A uniform language for electronic data interchange.
Accept assignment
Provider accepts as payment in full whatever is paid on the claim by the payer.