Billing Terms

1. Occurs when a patient has more than one insurance plan.
2. Requires the patient to use a primary care physician and stay within network.
5. The amount a patient must pay the provider generally before they receive any treatment or service.
6. The responsible party who pays for for a patient's medical expenses.
9. A document issued by the insurance company in response to a claim submission, that outlines what services were or were not covered, how much was paid, and how much the patient owes.
11. Facilities that review medical claims before sending them to the insurance company.
12. The amount the patient pays before the health plan begins to pay.

1. An amount or cost shared by the patient and the health plan.
3. A secondary policy or another insurance company that covers a patient's healthcare costs.
4. Delivers Medicaid program healthcare services to patients.
7. A claim filed by a provider after they have filed claims for the primary and secondary health insurance coverage on behalf of the patient.
8. The refusal of an insurance company or carrier to honor a request made by the provider to pay for healthcare services.
10. Allows patients to visit any provider contracted with their insurance.