Across
- 3. procedures or services performed that require a hospital stay.
- 6. a written approval from your provider or insurance company for specific care.
- 12. the provider group that is coordinating care.
- 13. the contracted rate for charges agreed upon between the payer and provider.
- 15. a percentage of the total cost for a medical service the patient will owe.
- 16. a set dollar amount that must be paid by the patinet before the insurance company will pay for any services.
- 18. hybrid of HMO and PPO insurance plans.
- 19. a set dollar amount a patient owes for their medical services.
- 20. a list of restrictions or maximum amounts set forth by the insurance payer.
Down
- 1. a network of medical providers that are contracted with an insured at pre-negotiated rates.
- 2. an insurance website that has electronic coverage information available.
- 4. everyone on the plan will be required to reach a shared dollar threshold.
- 5. the provider that is coordinating care.
- 7. the status of an insurance plan.
- 8. a group of health care providers that an insurance plan has not contracted or affiliated with.
- 9. a type of health insurance plan that usually limits coverage to care from doctors who work for or are contracted with a predefined group.
- 10. everyone on the plan will be required to reach individual dollar thresholds.
- 11. third or third in order.
- 14. the maximum amount of money a patient will pay out of pocket in a year.
- 17. the agreed services or items that an insurance plan will pay for at the plan specific rates.