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By Abby Hernandez R CMA 1/2

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Term
Definition
show Healthcare coverage provided by a private company, not the government  
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Primary Insurance   show
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Premium   show
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show The second health plan when you have more than one health insurance plan  
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show Acting as your own insurance company to cover your own losses  
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Self pay   show
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Government Plans   show
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show A fixed out-of-pocket amount paid by an insured for covered services  
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Deductibles   show
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Explanation of benefits (EOB)   show
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Co-insurance   show
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show Is a document that provides essential information about your claim payments  
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show Patients make informed decisions about items and services Medicare usually covers but may not in specific situations  
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Medicare   show
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Tricare   show
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show It covers vision benefits for diabetes patients only. Dental benefits are limited. For most care, including medical screening, mental health, emergency room, hospital stay, ambulance, vaccinations, office visits  
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show A federal system of health insurance for those requiring financial assistance  
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show a government-mandated program that provides benefits to workers who become injured or ill on the job or as a result of the job  
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CHIP   show
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Group Policies   show
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Individual Policies   show
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HMO (Health Maintenance Organization   show
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PPO (Preferred Provider Organization)   show
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Health Savings Account (HAS)   show
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Flexible Spending Account (FSA)   show
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show Is a tool that assigns codes for diseases, symptoms, abnormal findings, and external causes of a disease or injury  
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show Upcoding occurs when a healthcare provider has submitted codes for more severe conditions than diagnosed for the patient to receive higher reimbursement  
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show Standard claim form  
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Referrals   show
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show A participating provider is a healthcare provider that has agreed to contract with an insurer or managed care plan to provide eligible services to individuals covered by its plan.  
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show If there is still a balance owed on that bill and the healthcare provider or hospital expects you to pay that balance, you’re being balance billed  
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Debt   show
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Accounts receivable   show
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show In healthcare refers to the aggregate of money owed by the health care practice or hospital to its suppliers and employees  
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show A type of credit insurance offered by lenders that provides coverage for your debt in the event  
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show Valuable resources and advantages that a healthcare organization possesses  
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Liabilities   show
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show Are often used interchangeably. An EMR allows the electronic entry, storage, and maintenance of digital medical data. EHR contains the patient's records from doctors and includes demographics, test results, medical history, history of illness  
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