advance beneficiary notice
fee schedule
list of charges for services performed
premium
payment for insurance
gate keeper
primary physician or health care professional assigned by the insurer to review the medical manangement of plan enrollees
lapse
termination of coverage due to failure to pay premium
allowed amount
The maximum allowed amount for a covered charge.
primary insurance
Health plan that pays benefits first
preauthorization
Requirement for medicare and insurance companies to obtain prior approval for surgery & other procedures for reimbursement.
electronic billing
Submission of a claim via computer to a computer.
deductible
an amount to be paid before insurance will pay
advance beneficiary notice
document that acknoledges patient responsibility for payment if Medicare denies the claim