Patient Access

4. Amount set by insurance that the patient owes at the time of service.
6. Partners with Community to assist patients in need of coverage.
8. A documented patient visit in EPIC.
9. Referenced Based Pricing employer-based plan that sets a cap on benefits.
10. Rule that states a patient must be searched using two unique identifiers (Last Name, First Name & DOB, SSN)
11. Law that protects patient privacy and information.
12. Patient information such as Name, DOB, address.
14. The portion of charges an insured person must pay before the insurance company makes any payment.
15. Any amount the patient owes the health system not covered by a third-party. Sometimes called out-of-pocket.

1. Person financially responsible for the patient.
2. The portion an insured patient owes after the deductible is met. Usually a percentage.
3. Approval required by insurance for certain services.
5. Real Time Eligibility a tool embedded in EPIC to verify eligibility through Availity.
7. Indiana Medicaid Website. Verify current coverage and check self-pay patients for coverage.
12. An insurance company's formal rejection of a medical claim.
13. Insurance that Community is not in-network with, patients need to sign NonCover letter or seek care at in-network facility.