Insurance 101

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Across
  1. 4. The patients share of the costs of a covered health care service, calculated as a percentage
  2. 8. The amount the patient has to pay out-of-pocket for expenses before the insurance company will cover the remaining costs Deductible obligations exclude copayments
  3. 9. Advantage, Replacement Policy or Medicare Part C: A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits, in addition to RX and dental benefits
  4. 12. Accounts Receivable
  5. 14. Third Party Liability (ex: workers compensation)
  6. 16. Remittance Advice Remark Code; Supplemental to a CARC
  7. 17. Software as a Service (QSI Dental Web/ QDW)
  8. 20. State administered health insurance program for low income or disabled patients
  9. 21. A child or other individual for whom a parent, relative, or other person may claim a personal exemption tax deduction and is eligible for health benefits under the subscribers health insurance policy
  10. 23. Explanation of Benefits
Down
  1. 1. Marian Smith is the
  2. 2. A type of health insurance arrangement that allows plan participants relative freedom to choose the doctors and hospitals they want to visit
  3. 3. : Park Dental's Clearinghouse
  4. 5. The process of paying claims submitted or denying them after comparing claims to the benefit or coverage requirements
  5. 6. Electronic Funds Transfer
  6. 7. Federally administered health insurance program for adults over 65, patients with disabilities and / or End Stage Renal Disease
  7. 10. Electronic Remittance Advice
  8. 11. Coordination of Benefits
  9. 13. Claim: Formerly called Claim Reversal; A provider initiated electronic void is the cancelation of an entire claim
  10. 14. The policy owner The person who pays health insurance premiums and / or is eligible for group health insurance benefits
  11. 15. A request for your health insurer or plan to review a decision or a grievance again
  12. 18. A request for payment that you or your health care provider submits to your health insurer after services are rendered
  13. 19. Prepaid Medical Assistance Programs
  14. 22. Electronic Claim Submission
  15. 23. : Electronic Data Interchange