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Related Flashcards
Cards In This Set
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Policy
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When an individual or business entity purchases insurance coverage, there is a written agreement
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Premium
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When a individual periodically pays a specific amount of of money for insurance coverage, that will cover losses, injuries, and illnesses.
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Fee-for-service
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A traditional type of healthcare policy whereby the provider charges a specific fee (typically the UCR fee), for each service rendered and is paid that fee by the patient or by the patient's insurance carrier
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Preventive medicine
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Wellness examinations that insurance companies pay for in order to catch an emerging illness in its early stage when it is more treatable, rather than wait until the individual develops a more serious condition for which treatment is much more costly.
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Group plan
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One insurance policy that covers a group of people
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Pre-existing conditions
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When illnesses or injuries that exist before the effective date of the policy.
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Cost sharing
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When the patient shares the cost of his or her medical care with the insurer.
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Indemnity plans
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A plan where patients can choose any healthcare provider they wanpatients can choose any healthcare provider they want and medical bills are sent to the insurance carrier and paid for according to the stipulations of the policy t and medical bills are sent to the insurance carrier and paid for according to the stipulations of the policy.
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Managed care plans
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Where members usually are limited to only providers who contract with the plan and benefits are paid according to the plan’s fee structure.
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Insured
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An individual who is covered by an insurer
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HMO
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An organized plan other than traditional indemnity health insurance that provides healthcare for its members.
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Insurance
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An as the act, system, or business of protecting property, life, one’s person, etc. against loss or harm arising in specified incidents, in return for payment.
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HIPAA
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