Across
- 6. For active or retired U.S. Armed forces, their families, & survivors
- 7. a maximum amount patient pays for covered services in a year, which includes deductibles, coinsurance, and co-pays
- 9. Any self-administered medications that needs to be picked up at a pharmacy or shipped to a patient’s home
- 11. Coverage type when a patient receives treatment administered by a physician for a specific diagnosis at a doctor's office or hospital facility
- 13. a dollar amount payment for a specified charge for a service such as office visits or prescriptions
- 16. ______ BCBS subscriber IDs begin with prefix of R
- 18. Insurance for patients 65+, receiving Social Security, or has End Stage Renal Disease
- 19. a review of clinical documentation to verify a procedure is medically necessary prior to the time the procedure is scheduled
Down
- 1. percentage proportion of reimbursement that patients are responsible for paying
- 2. a portion of health care expenses that patients must pay before insurance coverage kicks in
- 3. Commercial insurance through an employer or self-employees purchased through a Marketplace
- 4. ___________ is aligned to United world Life
- 5. helps pay Medicare PArt A and PArt B premiums, and other costs like deductible, co-insurance, and co-payments
- 8. A plan type where patients can see doctors in and out of their network. so referral specialist needed
- 10. secondary insurance to a Traditional Medicare and follow Medicare guidelines
- 12. A plan type where patient can be seen and treated by a physician in network. A referral is required by the PCP to see a specialist
- 14. Insurance for low income families or individuals, qualified pregnant women or children, or patient with disabilities
- 15. employers who have a self-funded health care plan may choose a TPA to help finance the health reimbursement
- 17. ________ BCBS’s subscriber IDs begin with HZN
- 20. a condition which makes a particular treatment or procedure advisable