Person entitled to receive benefits

An approval for a procedure or a referral

The monthly, quarterly or annual payment of money to an insurance company for providing certain benefits

Amount that must be paid out of pocket before the insurance company begins to pay

Number used by the IRS to identify a business for income tax reporting

Insurance that covers a group of people with a single contract through employer

A term sometimes applied to private insurance products that supplements Medicare insurance benefits

An approval for a procedure or a referral

An insurance claim form without errors or omissions

A form made by the Health Care Financing Admin.(now CMSI center for Medicare and Medicaid Services) to submit all Gov't sponsored claims

An insurance claim form without errors or omissions.

A term used for all healthcare plans that provide healthcare in return for a monthly fee using a set group of primary care doctors and hospitals.

A term used for all healthcare plans that provide healthcare in return for a monthly fee using a set group of primary care doctors and hospitals

The most amount of money allowed for a procedure or service.

Amount that must be paid out of pocket before the insurance company begins to pay.

Insurance against liability employers pay to give benefits to workers who injured or killed on the job.

The monthly, quarterly or annual payment of money to an insurance company for providing certain benefits

An approval for a procedure or a referral

When a case is reviewed to see if services are needed and if medical resources are used.

A form made by the Health Care Financing Admin.(now CMSI center for Medicare and Medicaid Services) to submit all Gov't sponsored claims.

Things, diseases, conditions on an insurance contract for which benefits are not paid.

Amount that must be paid out of pocket before the insurance company begins to pay

A term sometimes applied to private insurance products that supplements Medicare insurance benefits

A term used for all healthcare plans that provide healthcare in return for a monthly fee using a set group of primary care doctors and hospitals.

The monthly, quarterly or annual payment of money to an insurance company for providing certain benefits.

Health Maintenance Organization

Claims are returned unpaid to the provider for clarification of any questions and must be corrected before resubmission.

The most amount of money allowed for a procedure or service

A percentage paid upfront for medical services, similar to co-pay

The amount paid at the time of a medical service

The most amount of money allowed for a procedure or service.

The amount paid at the time of a medical service.

Amount that must be paid out of pocket before the insurance company begins to pay

Insurance that provides money to replace income when someone is unable to work because of illness, injury, disease

When a case is reviewed to see if services are needed and if medical resources are used.

Insurance against liability employers pay to give benefits to workers who injured or killed on the job.

An approval for a procedure or a referral.

Things, diseases, conditions on an insurance contract for which benefits are not paid.

Claims that contain errors or omissions that cannot be processed or must be processed by hand.

Insurance that covers a group of people with a single contract through employer.

A claim that is delayed because it cannot be processed (usually incompatible with the receiving system).

Explanation of Benefits

Insurance that provides money to replace income when someone is unable to work because of illness, injury, disease

A percentage paid upfront for medical services, similar to co-pay

Insurance against liability employers pay to give benefits to workers who injured or killed on the job

Claims are returned unpaid to the provider for clarification of any questions and must be corrected before resubmission.

A claim that is delayed because it cannot be processed (usually incompatible with the receiving system)

An insurance claim form without errors or omissions

A claim that is delayed because it cannot be processed (usually incompatible with the receiving system).

Claims that contain errors or omissions that cannot be processed or must be processed by hand.

An insurance claim form without errors or omissions

A claim that is delayed because it cannot be processed (usually incompatible with the receiving system).

Claims that contain errors or omissions that cannot be processed or must be processed by hand.

Claims are returned unpaid to the provider for clarification of any questions and must be corrected before resubmission.

Claims that contain errors or omissions that cannot be processed or must be processed by hand.

An insurance claim form without errors or omissions

Claims are returned unpaid to the provider for clarification of any questions and must be corrected before resubmission.

Independent Practice Association

Explanation of Benefits

The most amount of money allowed for a procedure or service

Preferred Provider Organization

Insurance that covers a group of people with a single contract through employer

Health Maintenance Organization

Preferred Provider Organization

Insurance that provides money to replace income when someone is unable to work because of illness, injury, disease.

Insurance against liability employers pay to give benefits to workers who injured or killed on the job

Claims that contain errors or omissions that cannot be processed or must be processed by hand

Independent Practice Association

An insurance claim form without errors or omissions

Number used by the IRS to identify a business for income tax reporting.

A percentage paid upfront for medical services, similar to co-pay

The most amount of money allowed for a procedure or service