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SPH Rev Cycle Crossword

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Across
6
Collection of hospitals, doctors, and other services all organized under one network
7
Insurance companies and hospitals watch their costs and quality by having medical personnel review select medical cases.
9
An insurance company's decision to withhold a claim payment
11
Doctor you choose to provide basic health care
13
The most that your insurance will pay for a service
14
Federal program that insures elderly and disabled primarily
15
A request to your insurance company to pay for a service
17
Most you pay during a year before you health plan covers 100%
19
The facilities, providers, labs, hospitals, and pharmacies that your health plan has contracts with to provide care
20
Allows former employees, retirees, and their dependents to keep existing health coverage at group rates
Down
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The fee you pay to have insurance
2
Amount you pay for covered health care services before insurance starts to pay
3
Written contract between a policy holder and the insurance company
4
Kind of network with several cost levels
5
Process where health plan must approve coverage for a service that your provider requests
8
Annual time period during which you can change health plans under your employers group plan.
10
Percentage of allowed amount for a service
12
The scope of protection provided by an insurance contract which includes listed benefits in an insurance policy
16
Insurance companies contract with doctors, hospitals, and other providers to form a "network"
18
Fixed amount that you pay for a service