Insurance Basics Crossword

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Across
  1. 2. Determines when the benefits reset
  2. 3. How long the patient must be on the plan before the insurance carrier will pay for a specific service.
  3. 7. How often the carrier will pay for a service
  4. 8. Amount the patient must pay before the insurance company will pay for services.
  5. 9. same information as the EOB but sent to the office electronically.
  6. 11. The calculation of the fee difference between the procedure that was done and the one they will pay for.
  7. 13. Explains how the carrier processed the claim
  8. 14. When the insurance company will not pay for a service.
  9. 15. Controls how the insurance plan will calculate benefits when it is the secondary insurance.
  10. 16. The highest amount of money the carrier will pay in a given benefit year for services.
Down
  1. 1. Amount a patient must pay after the UCR fee is subtracted from the estimated insurance payment
  2. 4. Instead of paying a percentage of the fee, the patient pays a set amount.
  3. 5. Fees agreed to when you are contracted with a carrier and you agree to not charge the patient more than this fee.
  4. 6. Insurance Company
  5. 10. Office fees
  6. 12. The difference between the office's UCR fee schedule and the Carrier fee schedule.