Insurance

3. Which third-party payer is a combination of the HMO and PPO plan, yet allows members to go outside the HMO to obtain services?
5. Statement from the health insurance plan describing what costs it will cover for medical care or products you've received.
7. You agree to cover your old high schools rugby tournament. The coach asks you what type of insurance coverage you need.
10. The main source of insurance coverage for a patient or athlete.
11. Insurance plan that requires a primary-care physician "gatekeeper."
14. An addition to an existing insurance policy that allows you to add specific insurance products to basic coverage.
15. Amount of money a policyholder pays out of pocket before their insurance company begins covering covered expenses.
16. What type of code identifies specific medical procedures used in treating a patient?
17. The generic amount paid per service, negotiated and agreed upon. Sometimes used to determine the allowed amount.

1. Policy holders have the right to ask that their plans reconsider denial of payment.
2. The amount the patient pays for covered health care after meeting the deductible vs the amount the insurance company pays. A percentage of total cost.
4. Which third-party payer would provide financial medical assistance to an athlete with low SES?
6. Insurance coverage that pays after the primary coverage.
8. Any healthcare provider who uses electronic transactions is required to have a(n):
9. Insurance plan that allows you to visit any doctor or hospital without a referral.
12. A federal insurance program for people aged 65 years or older and with certain disabilities.
13. The amount of money an individual or business pays to an insurance company to keep their policy active on a monthly or annual basis.