Health Insurance Terms 2

5. A way to figure out who pays first when two or more policies or plans are responsible for paying the same medical claim (3 words).
7. A provider who has a contract with a health insurer or plan to provide services to members at a discount to the health insurer(2 words).
9. Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems (2 words).
10. A contract that requires a health insurer to pay some or all of an individual’s health care costs in exchange for a premium (2 words).

1. A statement sent from the health insurance company to a member listing services that were billed by a health care provider, how those charges were processed, and the total amount of patient responsibility for the claim (3 words).
2. Health care services that a policy or plan does not pay for/cover(2 words).
3. The sharing of costs covered by a policy or plan that a member pays out of pocket (2 words).
4. The facilities, providers and suppliers a health insurance company has contracted with to provide health care services to their members.
6. The health care items or services covered under a policy or plan.
8. A benefit an employer, union or other group sponsor provides to an individual or family to pay some or all for their health care services (2 words).
11. Acronym for a managed care plan that features higher deductibles than traditional insurance plans.
12. A request for payment that a patient or their health care provider submits to the health insurer when a service or item is provided and thought to be covered.