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Billing Vocabulary

Across
A percentage of the bill that a payer and the patient pays
Government insurance program started in 1965 that provides health coverage for those 65 and older
Insurance company decides who is in the acceptable provider network
A list of diagnoses, procedures and charges for a patients visit
Law passed in 1996 that protects the medical record
Insurance payments paid directly to the healthcare provider for medical services
The amount an insurance company will pay to reimburse a healthcare service
A payer's decision about the benefits due for a claim
A document attached to a processed claim that explains the provider and patient which services an insurance company will cover
A claim received by an insurance payer that is free from errors and processed in a timely manner.
Health insurance for active service members and their families
Down
An arrangement between a healthcare provider and an insurance payer that pays the provider a fixed sum for every patient they take on
The process followed by health plans to examine claims and determine benefits
Government insurance plan provided to low-income families and individuals who cannot afford full coverage
Yearly amount a patient owes according to their medical insurance plan
A medicare representative who processes medicare claims
A patient who does not have health insurance
Process by which a patient or provider attempts to persuade an insurance payer to pay for more of a medical claim.
A third-party organization in the billing process, and separate from the healthcare provider and the insurance payer
The uniformed service memberin a family qualified for Tricare
Network of healthcare providers that offer coverage to patients for medical services exclusively within a network
A federal program that grants a person who recently left their job to keep their health insurance
A federal agency that manages and oversees healthcare coverage through Medicare and Medicaid.