Revenue Cycle Healthcare Terms

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Across
  1. 4. annually renewed amount of maximum out of pocket costs for guarantor copays may contribute to OOP Max deductibles and co-insurances contribute to OOP Max
  2. 7. percentage ins covers after ded has been met
  3. 8. we are contracted but at Out of Network Rates
  4. 10. flat amount due every time for service
  5. 11. monthly amount due to have ins coverage
  6. 14. Fee for drs ect that are seeing the patient.
  7. 15. someone who is covered
  8. 17. Charges that are carved out of the reimbursement and
  9. 18. Person financially responsible for the bill
  10. 20. type of insurance coverage that covers the cost of an insured individual's medical
  11. 21. comprehensive health care reform law enacted in March 2010
  12. 22. when a patient is admitted in the hospital
  13. 25. procedure that is performed under anesthesia
  14. 26. Processes claims and provides administrative services
  15. 27. amount renewed annually based on policy due prior to insurance coverage
Down
  1. 1. we do not have a contract with the payer
  2. 2. service may be covered but NOT authorized yet
  3. 3. primary policy holder
  4. 5. organizations in each state through which people can purchase health insurance
  5. 6. patient stays up to 72 hours but not be inpatient
  6. 9. component of a charge addresses the use of equipment facilities non-physician medical staff supplies ect
  7. 12. most common guarantor used
  8. 13. services for trauma or urgent care EMTLA applies
  9. 16. service in a hospital or HOD but not as an inpatient
  10. 19. financially responsible party
  11. 23. Permission that ins covering for service
  12. 24. letter from physician stating need for other services