K
A set amount that is charged and paid at the time of service for certain types of medical services.
What is Copay?
A percentage that insurance indicates the patient is responsible for, meaning the patient and the insurance company will share the cost of service.
What is Coinsurance?
An annual amount the patient is responsible for under their health plan before the health plan will begin to pay for services.
What is annual deductible?
The portion of medical expenses the patient is responsible for paying when they receive medical care.
What is Out of Pocket (OOP)?
An annual amount that is the highest or total amount the health plan will require to pay towards the cost of their healthcare.
What is annual OOP maximum?
Providers/hospitals that contract with the Payor and agree to accept a discounted rate for services provided.
What is In Network?
Providers/hospitals that are not contracted with the Payor.
What is Out of Network (OON)?
The person in whose name the insurance is issued.
What is subscriber?
An insurance company
What is Payor?
A person covered under an insurance plan.
What is a member?
A set of benefits offered by an insurance company.
What is plan?
Use this when Passport is down/unavailable.
What is Override Query?
Gives information about the patient's eligibility information for coverage, along with benefit information.
What is Response History?
Epic will electronically verify eligibility when this is enabled.
What is Real Time Eligibility (RTE)?
The third-party vendor used to verify eligibility.
What is Passport?
This icon lets you know coverage can be electronically verified.
What is lightning bolt?
What is Effective From?
What is Effective To?
New, Elapsed, or E-Verified are examples of...
What is Automatic Verification Statuses?
Needs Review, Coverage to be Deleted, or Verified by Fax, Phone, or Website are examples of...
What is Manual Verification Status?
This activity helps record and store benefit information for a specific visit or hospital stay.
What is Benefit Collection Acitivity?
This record holds insurance information.
What is Coverage Record?
Insurance that is obtained through an employer or COBRA.
What is Commercial Insurance?
Federal Government system of health insurance based on eligibility guidelines.
What is Medicare/Medicare Advantage plan?
This act allows patients to sign up through Healthcare Exchange to purchase a private coverage that is not through employment.
What is the Affordable Care Act?