Medical Benefits

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Across
  1. 3. What a provider can submit prior to services being rendered to see if the procedures would be approved by insurance for coverage
  2. 7. TeamCare's voluntary Telemedicine vendor
  3. 8. TeamCare's voluntary imaging benefit vendor
  4. 9. Generally seen on retiree plans, this refers to the total amount of payments that can be made in a calendar year towards a member's medical benefits
  5. 10. Covered at 100% with no copay through an in network provider this benefit can include coverage for routine check ups, physicals, immunizations, and breast pumps
  6. 12. The percentage that a member has to pay after meeting their deductible
  7. 13. The benefit that would cover a member's surgical procedures, and the birth of a child
  8. 16. The amount of covered expenses that an individual must satisfy before being eligible for payment of any benefit
  9. 17. This benefit would cover a member's inpatient hospital stay
  10. 18. Oxygen equipment, wheelchairs, and crutches are examples of this, equipment and supplies ordered by a healthcare provider for everyday or extended use
  11. 19. The portion that the member must pay prior to the insurance covering all covered services at 100%
  12. 21. The medical network for members living in the state of Ohio
  13. 23. The portion a member would pay an in network provider for a sick office visit
  14. 24. If a member spends longer than 24 hours in a hospital or facility the patient is considered to be
  15. 25. The medical network may require this type of prior authorization to get a member pre-approved for a procedure or inpatient stay according to their guidelines
Down
  1. 1. TeamCare's pharmacy vendor
  2. 2. The benefit that would cover such things as durable medical equipment, and physical therapy
  3. 4. The term when a member authorizes TeamCare to pay their claim directly to their provider
  4. 5. TeamCare's voluntary lab benefit vendor
  5. 6. This benefit would cover mental health and drug rehab visits for both inpatient and outpatient
  6. 11. The medical network for all of our members outside of Ohio
  7. 14. This benefit can cover a member who has been in an accident for the first date of treatment, and must be within 5 days of the accident
  8. 15. A long term medication that should be filled in a 90 day supply through CVS for the best coverage
  9. 17. Type of service that providers render in a patient's home, and can encompass a wide range of treatments
  10. 20. If the member's services require less than 24 hours in a hospital, office, or facility the services are considered to be
  11. 22. A medical billing code that can be used in CSI to look up specific medical procedures