Benefits Terminology

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Across
  1. 2. Used to look up codes provided by a member (Three words).
  2. 3. Flat fee paid at the time of service.
  3. 5. Provider that is a hospital or freestanding ER (two words).
  4. 8. The benefit database (Three words).
  5. 9. The most a plan will pay for a service under contract (Two words).
  6. 11. Provider that is a person or non-hospital (Two words).
Down
  1. 1. Set amount to pay before benefits are paid by insurance.
  2. 4. Confirmation that the service meets medical necessity.
  3. 6. The "buckets" that track money paid out by the member.
  4. 7. The system that guides a CA through questions and steps to pull up the correct benefit information (Two words).
  5. 10. Percentage of costs paid after the deductible.
  6. 12. Monthly fee for health coverage.