Vocabulary Review

1. Allowed charge is the maximum amount of money many third-party payers allow for a specific procedure or service.
2. An alphanumeric number issued by the insurance company giving approval of a procedure or service is a(n) authorization.
3. An individual entitled to receive benefits from an insurance policy or program or from a government entitlement program offering healthcare benefits is considered the beneficiary.
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6. Capitation is a payment method used by many managed care organizations in which a fixed amount of money is reimbursed to the provider for patients enrolled during a specific period of time, no matter what services were received or how many visits were made.
7. In the insurance business, companies that assume the risk of an insurance policy are considered the carrier.
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9. The health benefits program run by the Department of Veterans Affairs (VA) that helps eligible beneficiaries pay the cost of specific healthcare services and supplies is the (give full name and acronym) Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)
10. A(n) co-insurance provision frequently is found in medical insurance policies whereby the policyholder and the insurance company share the cost of covered losses in a specified ratio.
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12. A(n) co-payment is the sum of money paid at the time of medical service; it is a form of coinsurance.
13. Typically met on a yearly or per-incident basis, this specific amount of money, a(n) deductible is what a patient must pay out of pocket before the insurance carrier begins paying.
14. Dependents are the spouse, children, and sometimes domestic partnet or other individuals designated by the insured who are covered under a healthcare plan.
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16. The effective date is the date on which an insurance policy or plan takes effect so that benefits are payable.
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