#1
What does the term 'co-payment' refer to in health insurance?
A fixed amount paid by an insured individual for covered services, typically due at the time of service.
ExplanationFixed fee paid by the insured for covered services.
#2
What is a 'deductible' in health insurance terminology?
The total amount of money an insured individual must pay out of pocket for healthcare services before the insurance company begins to pay.
ExplanationOut-of-pocket amount paid by the insured before insurance coverage starts.
#3
What does 'HIPAA' refer to in the healthcare industry?
Health Insurance Portability and Accountability Act
ExplanationRegulation ensuring privacy and security of health information.
#4
In health insurance, what is the 'network'?
A group of healthcare providers and facilities that have contracts with a health insurance company to provide services at negotiated rates.
ExplanationProviders under contract to offer services at agreed rates.
#5
What does 'EHR' stand for in healthcare?
Electronic Health Record
ExplanationDigital record of an individual's health information.
#6
What is 'PHR' in the context of healthcare?
Personal Health Record
ExplanationIndividual's digital health information record.
#7
What does 'DOB' stand for in medical billing?
Date of Birth
ExplanationIndividual's birth date for identification.
#8
What does 'HMO' stand for in health insurance?
Health Maintenance Organization
ExplanationHealthcare provider network with negotiated rates for insurance members.
#9
In medical billing, what does 'CMS' typically refer to?
Center for Medicare and Medicaid Services
ExplanationGovernment agency overseeing Medicare and Medicaid programs.
#10
What does the term 'EOB' stand for in medical billing?
Explanation of Benefits
ExplanationDocument explaining covered healthcare services and costs.
#11
What is 'CPT' in medical coding and billing?
Current Procedural Terminology
ExplanationStandardized codes for medical procedures in billing.
#12
What is 'pre-authorization' in the context of health insurance?
A process by which a healthcare provider gets approval from a health insurance company before providing certain services.
ExplanationApproval process for specific healthcare services.
#13
What is 'COBRA' in the context of health insurance?
A federal law that allows individuals to continue their group health insurance coverage for a limited time after leaving employment.
ExplanationLegislation enabling continued coverage after job loss.
#14
What does 'PHI' mean in healthcare?
Protected Health Information
ExplanationConfidential and protected health-related data.
#15
What is 'ICD-10' in the context of medical billing?
A standardized system of medical codes used for billing purposes.
ExplanationStandardized coding system for medical billing purposes.
#16
What does 'U&C' mean in medical billing?
Usual and Customary
ExplanationStandard and regular charges for medical services.
#17
What does 'NPI' stand for in medical billing?
National Provider Identifier
ExplanationUnique identifier for healthcare providers in billing.
#18
What is 'PAR' in the context of healthcare?
Preferred Allowable Rate
ExplanationAgreed-upon rate between providers and insurance for services.