Healthcare Financing

2. policy-determined set amount paid to the provider for each visit
3. services the insurance company covers
7. predetermined payment (by the insurance company) for care provided by healthcare organizations based on diagnosis at time of admission
8. payment the insurance company gives the healthcare provider for services they have determined are necessary & have billed for
10. a list of medications the insurance company will cover
11. policy-determined amount you need to pay first before the insurance company starts paying
12. when people are insured, they tend to use the healthcare system more frequently; it is SUGGESTED they may engage in high-risk behavior more frequently due to better access to healthcare
13. the limit on the amount that the healthcare provider and insurance company have negotiated and agreed to charge for services that are provided, regardless of number of office visits
14. what you pay the insurance company to have a policy
15. a comparison-shopping area for health insurance; private companies list health plans and people comparison shop from available listings

1. predetermined/agreed upon amount the insurance company will reimburse to the healthcare provider for specific types of provided services
4. payment determined following provision of services
5. a provider contracted by an insurance company who provides care to those enrolled in that company's plan(s)
6. implementing policy changes slowly/incrementally so people can get used to it
9. the percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible; the insurance company, however, often has an allowable amount for certain services it is willing to pay, and you are required to pay whatever is leftover