CH 24

2. a specified amount the insured must pay toward the charge for professional services rendered at the time of service
3. a type of managed care operation that is typically set up as a for-profit corporation with salaried employees; group insurance that entitles members to services provided by participating hospitals, clinics, and providers
6. an amount to be paid before insurance will pay
9. a phrase coined to indicate payment of services rendered by someone other than the patient
10. an organization of physicians who network together to offer discounts to purchasers of health care insurance
11. a joint funding program by federal and state governments (excluding Arizona) for the medical care of low-income patients on public assistance
12. one step removed from the first; not primary

1. prior approval of insurance coverage and necessity of procedure; refers to obtaining plan approval for services prior to the patient receiving them
4. person entitled to benefits of an insurance policy. This term is most widely used by Medicare
5. The insurance of the parent with the birthday earliest in the year, month and day only, is identified as the primary insurer
7. person covered under a subscriber’s insurance policy;refers to spouses and dependent children
8. a federal program for providing health care coverage for individuals over the age of 65 or those who are disabled
10. occurring first in time, development, or sequence; earliest
13. the standard claim form designed by the Centers for Medicare and Medicaid Services to submit physician services