Health Insurance Terminalogy
Across
- 3. An amount of money that an insured person must pay annually before health services are covered by the insurance plan.
- 7. A fixed amount of money that the patient must pay for any health care service.
- 8. The health care practitioner chosen by a patient to provide general medical care and also to determine and authorize additional medical services the patient may require.
- 10. The directing of a patient to a specialist physician by the primary care provider. Most managed care plans and some other insurance plans require the primary care provider to obtain prior authorization.
- 14. A percentage of the allowed charge for health services, which the patient is responsible for paying.
- 15. The amount paid by insurance for health care services.
- 16. A physician who has a contractual agreement with a third-party payor.
- 17. An amount of money paid in a given period to purchase health insurance.
- 18. insurance The insurance company that must be billed first for any individual.
- 20. The individual who has a specific insurance plan.
- 21. Rules followed by insurance companies so that no claim is reimbursed at more than 100% of the charges.
Down
- 1. An insurance carrier's official list of covered medications to be used by network providers.
- 2. The federal health insurance program that provides insurance coverage for the elderly, permanently disabled, and individuals with end-stage renal disease.
- 4. Enrollment status related to a health insurance plan.
- 5. A statement issued by the insurance carrier explaining reimbursement for specific procedures.
- 6. A person who can receive benefits under an insurance plan.
- 9. Verification from a patient's insurance carrier that a procedure is covered by the patient's insurance and/or agreement, after review, that the test or procedure is medically appropriate.
- 11. Verification from a patient's insurance carrier that a procedure is covered by the patient's insurance and/or agreement, after review, that the test or procedure is medically appropriate.
- 12. Payment for a covered service under a health insurance plan.
- 13. A method of paying for insurance in which a fixed amount is paid to the provider per member for a specific time period regardless of the amount of care provided.
- 19. The government insurance program for low-income individuals and families that is funded both by the federal government and by each individual state.