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insurance terms

insurance terminology

TermDefinition
Advance beneficiary notice (ABN) form provided to the patient when the provider believes medicare will probably not pay for services received
allowed amount the maximum amount a third party payer will pay for a particular procedure or service.
copayment an amount of money that is paid at the time of medical service.
coinsurance a policy provision frequently found in medical insurance whereby the policyholder and the insurance company share the cost of covered losses in a specified ratio, such as 80:20
deductible a specific amount of money a patient must pay out of pocket before the insurance carrier begins playing
explanation of benefits a statement from the insurance carrier detailing what was paid, denied, or reduced in payment; also contains info about amounts applied to the deductible, coinsurance, and allowed amounts.
participating provider (PAR) providers who agree to write off the difference
Created by: elshalance
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