| A | B |
|---|
| Assignment of Benefits | authorization to pay physician directly |
| Release of Medical Information form | authorization to release patient info to the insurance company |
| Capitiation | fixed amount paid to Dr monthly regardless of services provided |
| Claim | request for insurance payment |
| Coordination of Benefits | procedures used when patient has more than one insurance |
| Copayment or Coinsurance | specific amount the insured must pay the Dr for services |
| Deductible | amount insured must pay each year before insurance begins to pay |
| Group insurance | health insurance offered by employers |
| HCFA 1500 | standard claim form |
| HMO | health maintance organization |
| Premium | money paid to purchase insurance |
| ICD-9-CM | coding system used to document disease injury illness and mortality |
| HCPCS/CPT | procedure coding system |
| Managed Care | system in which medical teams are organized into groups |
| Medicaid | funding program for health coverage for the poor |
| Medicare | government insurance for people over 65 and permenantly disabled |
| Medigap | insurance that pays for services not covered by medicare |
| Pre-certification | authorization obtained from insurance company prior to services being rendered |
| Preexisting condition | medical condition that a patient had before owning the insurance |
| PPO | preferred provider organization, managed care that allows members to seek service from non-network Dr at higher cost |
| Subscriber | person who owns the insurance policy |
| Tricare/CHAMPUS/CHAMPUSVA | insurance for military personal and their families |
| DRG | diagnostic related groups coding group for diseases |
