provider - general correct answers A party rendering medical care such as a physician or hopsital
facilities provider correct answers Includes
... [Show More] hospitals, skilled nursing facilities, assisted living facilities, home health agencies, and ambulatory centers
professional provider correct answers includes physicians, pharmacists, nurses, therapists, and allied health professionals
primary care correct answers primary care physicians are usually trained in family practice, general practice, general internal medicine, and pediatrics. Physicians serving in primary care roles usually treat common medical conditions or injuries, and often provide preventive health screenings. They are often viewed as serving as a coordinator of a patient's care, assessing a patient's condition, and treating if a simple condition, or referring a patient to a specialist physician.
specialist correct answers specialists normally do not provide primary care services, instead focusing their work based on in-depth training in different diseases, body systems or types of health care service
third party payer correct answers a health insurance plan paying for the services
out-of-pocket-payment correct answers payments by patients that can be required as a part of a health insurance plan are: deductible, copayment, and coinsurance
deductible correct answers the deductible is a pre-determined amount that the patient pays before the insurer begins to pay for service
coinsurance correct answers corinsurance is a percentage of the insurance payment amount that is paid by the patient, along with the amount paid by the insurerer
indemnify correct answers payment on behalf of the patient - costs covered under the insurance contract between the patient and the insurer
claim correct answers a bill for services provided
pre-authroization correct answers permission by the insurer to render services to the patient before actually treating the patient. This includes verification of payment for the service by the insurer
benefit payment correct answers once the insurer has determined the claim is appropriate, a payment is made to the provider. This payment is officially termed a benefit payment
beneficiary correct answers insurers usually refer to the patient for which services are paid as the beneficiary [Show Less]