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HEALTHCARE 101

Operation Support 2017
Across
USMD MISSION
Statement sent by the insurance company providing billed charges or amount billed for medical services that were paid on their behalf
Approval from the insurance company outpatient medical services, durable medical equipment and other item
PCP requests approval to seek services from Specialists
Down
The amount (percentage) the insured has to pay for covered health care expenses after the deductible is met.
Plan that requires patient to select a PCP
The amount of money that the insured must pay in a policy year for covered health care expenses before the Payer starts paying.
Patient does not have verifiable proof of insurance
A limit on the amount you pay for covered health services (during the policy year), after you have paid your deductible
A fixed cost shared amount paid by the patient at each visit. It is a portion of the plan allowable paid for the service.