Insurance Review Committee Crossword Puzzle

3. procedures or services performed that require a hospital stay.
6. a written approval from your provider or insurance company for specific care.
12. the provider group that is coordinating care.
13. the contracted rate for charges agreed upon between the payer and provider.
15. a percentage of the total cost for a medical service the patient will owe.
16. a set dollar amount that must be paid by the patinet before the insurance company will pay for any services.
18. hybrid of HMO and PPO insurance plans.
19. a set dollar amount a patient owes for their medical services.
20. a list of restrictions or maximum amounts set forth by the insurance payer.

1. a network of medical providers that are contracted with an insured at pre-negotiated rates.
2. an insurance website that has electronic coverage information available.
4. everyone on the plan will be required to reach a shared dollar threshold.
5. the provider that is coordinating care.
7. the status of an insurance plan.
8. a group of health care providers that an insurance plan has not contracted or affiliated with.
9. a type of health insurance plan that usually limits coverage to care from doctors who work for or are contracted with a predefined group.
10. everyone on the plan will be required to reach individual dollar thresholds.
11. third or third in order.
14. the maximum amount of money a patient will pay out of pocket in a year.
17. the agreed services or items that an insurance plan will pay for at the plan specific rates.