Revenue Cycle Healthcare Terms

4. annually renewed amount of maximum out of pocket costs for guarantor copays may contribute to OOP Max deductibles and co-insurances contribute to OOP Max
7. percentage ins covers after ded has been met
8. we are contracted but at Out of Network Rates
10. flat amount due every time for service
11. monthly amount due to have ins coverage
14. Fee for drs ect that are seeing the patient.
15. someone who is covered
17. Charges that are carved out of the reimbursement and
18. Person financially responsible for the bill
20. type of insurance coverage that covers the cost of an insured individual's medical
21. comprehensive health care reform law enacted in March 2010
22. when a patient is admitted in the hospital
25. procedure that is performed under anesthesia
26. Processes claims and provides administrative services
27. amount renewed annually based on policy due prior to insurance coverage

1. we do not have a contract with the payer
2. service may be covered but NOT authorized yet
3. primary policy holder
5. organizations in each state through which people can purchase health insurance
6. patient stays up to 72 hours but not be inpatient
9. component of a charge addresses the use of equipment facilities non-physician medical staff supplies ect
12. most common guarantor used
13. services for trauma or urgent care EMTLA applies
16. service in a hospital or HOD but not as an inpatient
19. financially responsible party
23. Permission that ins covering for service
24. letter from physician stating need for other services