Healthcare Vocabulary Crossword
Type
Crossword
Description

A contract with a company where the subscriber pays a regular premium in exchange for a defined set of benefits
Reffered to as family doctor/PCP this person administers routine and preventive care, and makes referrals for specialty services when needed.
A provider who focuses on one area of medicine. Like a cardiologist or neurologist
A contracted, pre-determined dollar amount insurance company requires a patient to pay for a particular medical service. (It requires patients to pay a small amount upfront to deter people from seeking medical care that may not be necessary.)
The contracted rate a health insurance company will pay toward a specific medical service.
A contracted, pre-determined percentage of the allowable charge that a patient is required to pay for a particular medical service (after the deductible is met and before the out-of-pocket maximum is met).
A pre-determined annual amount patient must pay before insurance begins to cover.
Annual maximum amount patient is required to pay for in-network medical services per his/her insurance plan contract (typically, copay + coins + deductible)
The person who is responsible for payment of the monthly premium, or whose employment is the basis for the coverage.
A person entitled to health insurance benefits under the subscriber’s plan.
Insurance Company
A specific package of benefits negotiated between the company and the employer.
Dates during which the insurance plan is active.
Explanation of Benefits is a statement from the insurance company that details payments and adjustments made for services. EOBs go to both the provider and the patient.
/Response from the insurance company that states no payment will be made. (service could be not covered by the insurance plan, or the insurance company may need more information.)
The order in which the claim is sent to insurance companies. If patient has more than one insurance plan, we must determine which insurance should be billed primary, secondary, etc. Primary: the first insurance company designated to pay toward their allowable charges. Secondary: the second insurance company designated to pay toward their allowable charges.
The pathway a patient takes from one provider to another. Referrals may be required by insurance before a patient can be seen by the other provider.
The process whereby a physician must obtain insurance approval before a patient receives certain treatment or drugs (study, test, procedure, surgery.)

Healthcare Vocabulary Crossword

Healthcare Vocabulary Crossword
Type
Crossword
Description

The pathway a patient takes from one provider to another. Referrals may be required by insurance before a patient can be seen by the other provider.
Dates during which the insurance plan is active.
A contract with a company where the subscriber pays a regular premium in exchange for a defined set of benefits
The order in which the claim is sent to insurance companies. If patient has more than one insurance plan, we must determine which insurance should be billed primary, secondary, etc. Primary: the first insurance company designated to pay toward their allowable charges. Secondary: the second insurance company designated to pay toward their allowable charges.
The contracted rate a health insurance company will pay toward a specific medical service.
A provider who focuses on one area of medicine. Like a cardiologist or neurologist
A pre-determined annual amount patient must pay before insurance begins to cover.
The person who is responsible for payment of the monthly premium, or whose employment is the basis for the coverage.
The process whereby a physician must obtain insurance approval before a patient receives certain treatment or drugs (study, test, procedure, surgery.)
A specific package of benefits negotiated between the company and the employer.
Response from the insurance company that states no payment will be made. (service could be not covered by the insurance plan, or the insurance company may need more information.)
Insurance Company
A contracted, pre-determined dollar amount insurance company requires a patient to pay for a particular medical service. (It requires patients to pay a small amount upfront to deter people from seeking medical care that may not be necessary.)
Reffered to as family doctor/PCP this person administers routine and preventive care, and makes referrals for specialty services when needed.
A contracted, pre-determined percentage of the allowable charge that a patient is required to pay for a particular medical service (after the deductible is met and before the out-of-pocket maximum is met).
Annual maximum amount patient is required to pay for in-network medical services per his/her insurance plan contract (typically, copay + coins + deductible)
Explanation of Benefits is a statement from the insurance company that details payments and adjustments made for services. EOBs go to both the provider and the patient.
A person entitled to health insurance benefits under the subscriber’s plan.

Basics of Health Insurance Crossword

Basics of Health Insurance Crossword
Type
Crossword
Description

An established schedule of fees set for services performed by providers and paid by the patient
protection in return for periodic premium payments that provides reimbursement of expenses resulting from illness or injury
the sum of money paid at the time of medical service; it is a form of coinsurance
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
Civilian Health and Medical Program of the Veterans Administration known as
states that when an individual is covered under two insurance policies, the insurance plan of the policyholder whose birthday comes first in the calendar year (month and day, not year) becomes the primary insurance.
A term used in managed care for an approved referral
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.
a letter or statement from Medicare that describes what was paid, denied, or reduced in payment.
Pays expenses involved in the care of the teeth and gums
Protects a person in the event of a certain type of accident, such as an airplane crash
Often includes benefits for medical expenses payable to individuals who are injured in the insured person’s home or during an automobile accident
Covers a continuum of maintenance and health services for chronically ill, disabled, or mentally retarded individuals
Provides payment of a specified amount on the insured’s death
Pays the cost of all or part of the insured person’s hospital room and board and specific hospital services
a review of individual cases by a committee to make sure services are medically necessary and to study how providers use medical care resources
40. An insurance term used when a primary care provider wants to send a patient to a specialist
periodic (monthly, quarterly, or annual) payment of a specific sum of money to an insurance company for which the insurer, in return, agrees to provide certain benefits
person who pays a premium to an insurance company and in whose name the policy is written in exchange for the insurance protection provided by a policy of insurance
a general practice or nonspecialist provider or physician responsible for the care of a patient for some health maintenance organizations

Medicare Terms Crossword

Medicare Terms Crossword
Type
Crossword
Description

means that your doctor, provider, or supplier must accept the Medicare-approved amount as full payment for covered services
this visit is available once every twelve months after the first twelve months of Part B coverage
the percentage you pay for covered services after you have met your deductible
a fixed amount one pays to receive a medical service, usually at the time of service
the amount one pays annually before the plan begins to pay. This does not apply to services that require a copay
is long lasting, used for a medical reason, and typically used in an individual's home
ESRD
the plan contract that gives detailed information about the plan, including: what is and is not covered, what an individual pays, etc.
a monthly summary sent to an individual to let them know what services were billed, what was paid by whom, and what amount the individual is responsible to pay.
in this type of plan you can only go to doctors, other health care providers, or hospitals in the plan’s network except in an urgent or emergency situation.
care that is usually given when an individual has decided that they no longer want care to cure terminal illness and/or one’s doctor has determined that efforts to cure an illness aren’t working.
a status for individuals starting when one is formally admitted to a hospital with a doctor’s order
a status for individuals getting emergency department services, observation services, surgery, lab tests, X-rays, or any other hospital services, and the doctor hasn’t written an order to admit them to a hospital as an inpatient
in a PPO, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network
the periodic payment to Medicare, an insurance company, or a health care plan for health or prescription drug coverage
services to prevent illness or detect illness at an early stage
the doctor you see first for most health problems
a written order from a primary care doctor for a patient to see a specialist or get certain medical services, often required by HMOs

PATIENT ACCESS Crossword

PATIENT ACCESS Crossword
Type
Crossword
Description

Health Maintenance Organization; A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the
Fixed sum of money that beneficiary must contribute towards the cost of their healthcare before insurance benefits begin
Official count/list of patient population
Not to be disclosed
Federal health insurance plan primarily for seniors
The administrative branch within the Department of Health and Human Services that is responsible for Medicare and Medicaid Services
ost sharing in which the subscriber is responsible for a specific percentage of the cost of healthcare
Person who is the holder of an insurance policy
Questionnaire to determine primary payor before Medicare
ederal law requiring employers to permit employees to continue their group health insurance coverage after termination
A fixed payment for a covered service
Preferred Provider Organization
oint federal and state program to provide Medical insurance for the poor
Collection and storage on patient demographic, insurance, and clinical data

Taxes and Paychecks Crossword

Taxes and Paychecks Crossword
Type
Crossword
Description

What is the other name for the Federal Insurance Contribution Act?
The amount taken from the employees paycheck for medical benefits?
What type of withholding tax is used to assist in funding government agencies within states?
The length of time for which an employee's wages are calculated?
What tax is based on 6.2% of employees gross income?
What type of tax is based on 1.45% of employees gross income?
Totals of all deductions which have been withheld from Jan. 1 to the last day of the pay period?
What is used to list paycheck deductions?
What is the total amount of money earned during the pay period before deductions?
What pay is the total amount of money left over after all deductions?
What is subtracted from the gross pay?
What type of withholding tax is required by law to withhold from wages to pay taxes?
What plan do employees contribute to each period?
Who is responsible for handling the paycheck?
What is the most secure paying method?
What are charges imposed on citizens by governments?
What is the service that collects federal taxes?
What is used to determine the amount of federal taxes withheld from the paycheck?
What is a person who relies on the taxpayer for financial support?
A driver's license, passport, and birth certificate are all forms of what?

Medicare 101 Crossword

Medicare 101 Crossword
Type
Crossword
Description

Groups of drugs that have a different cost for each group.
the action you can take if you disagree with a coverage or payment decision made by Medicare, your Medicare health plan, or your Medicare Prescription Drug Plan.
An agreement by your doctor, provider, or supplier to be paid directly by Medicare, to accept the payment amount Medicare approves for the service, and not to bill you for any more than the Medicare deductible and coinsurance.
A geographic area where a health insurance plan accepts members if it limits membership based on where people live.
A coverage rule used by some Medicare Prescription Drug Plans that requires you to try one or more similar, lower cost drugs to treat your condition before the plan will cover the prescribed drug.
A person who has health care insurance through the Medicare or Medicaid programs.
The way that Original Medicare measures your use of hospital and skilled nursing facility (SNF) services.
A written order from your primary care doctor for you to see a specialist or get certain medical services.
A request for payment that you submit to Medicare or other health insurance when you get items and services that you think are covered.
An amount you may be required to pay as your share of the cost for services after you pay any deductibles.
An amount added to your monthly premium for Part B or a Medicare drug plan (Part D) if you don't join when you're first eligible. You pay this higher amount as long as you have Medicare. There are some exceptions.
Approval that you must get from a Medicare drug plan before you fill your prescription in order for the prescription to be covered by your plan.
The amount you must pay for health care or prescriptions before Original Medicare, your prescription drug plan, or your other insurance begins to pay.
A type of Medicare prescription drug coverage determination, a drug plan's decision to cover a drug that's not on its drug list or to waive a coverage rule
A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits.
A complaint about the way your Medicare health plan or Medicare drug plan is giving care.
Health care that you get when you're admitted to a health care facility, like a hospital or skilled nursing facility.
The facilities, providers, and suppliers your health insurer or plan has contracted with to provide health care services.

Insurance Terms Crossword

Insurance Terms  Crossword
Type
Crossword
Description

Business person who analyzes the probabilities of risk/risk management.
Person who sells, services, or negotiates insurance policies either with a company or individually.
Physical injury that can include sickness/disease to a person
A clause in most property insurance policies to encourage policyholders to carry a good amount of insurance. If the insured person doesn’t maintain the amount specified in the clause (usually 80%), the insured person will share a higher proportion of the loss.
The date when an insurance company issues a policy.
Portion of the insured loss paid by the policyholder
Amount at which an asset can be bought or sold in a transaction between willing parties.
The termination of a policy due to failure to pay the required renewal premium.
It is a state assistance program, to provide hospital and medical expense insurance to people over 65 years of age.
Money charged for the insurance coverage reflecting expectation of loss.
Uncertainty including the possibility of loss by an unexpected event for which insurance is used for.
homeowners insurance sold to tenants living in the described property.
The person who identifies and classifies the degree of risk posed by the person trying to be insured. They determine whether or not coverage should be provided and what the rate should be
Insurance that will cover an employer’s liability for injuries or death to people in their employment
The amount that has to be paid by the insured person during a calendar year before the insurer is responsible for more loss costs

Reading A Paycheck Stub Crossword

Reading A Paycheck Stub Crossword
Type
Crossword
Description

Lists paycheck deductions as well as other important info
The employee's full name, address, and social security #
Total amount of money earned during the pay period before deductions
total amount of money left after all deductions are taken out
The amount of money deducted from the gross pay for taxes, medicare, or benefits
The % deducted from an individual's paycheck to assist in funding the state
Federal Insurance Contribution Act
Nation's retirement program, provides retirement income for the elderly and pays disability
The nation's healthcare program for the elderly and disabled
The amount an employee contributes each pay period to a retirement plan
The amount taken from your paycheck for medical benefits
The amount by laws for employers to withhold from earned wages
Totals of all deductions from January 1st to the day of the pay period
Length of time for which an employee's wages are calculated
Compulsory charges imposed on citizens by local, state, and federal governments
Collects federal taxes, issues regulations, and enforces tax laws written by the U.S.
Employers directly deposit employee's paycheck into the employee's authorized account
Electronically carries the employee's net pay
Used to determine the amount of federal taxes withheld from the paycheck
A person who relies on the tax payer for financial support

Hospital Billing Crossword

Hospital Billing Crossword
Type
Crossword
Description

National Provider Identification
The note received from the insurance company after getting medical services from a doctor or hospital. It tells what was billed, the payment amount approved or denied by the insurance, the amount paid, and what the patient must pay.
Portion of the bill, as defined by the insurance company which the patient owes.
Advanced Beneficiary Notice
A person or persons whose account that has been sent to a collection agency for further action.
The cost sharing part of the bill that the patients have to pay.
A part of the bill that we must write off because of billing agreements with insurance companies.
A cost sharing part of the bill that is the patient’s responsibility to pay.
A coding system used to describe what treatment or services were given to the patient by their provider. Used for hospital outpatient services billed on an UB and professional services billed on HCFA 1500s
How much cost sharing that the patient must pay for medical services often before their insurance starts to pay.
A code used for billing that describes the patient’s condition. Also called ICD-10 diagnosis code.
Individual who is responsibility for the bill.
Patient class in which the patient requires a higher degree of nursing and physician care.
A person who is a policyholder of the insurance. Also known as the subscriber, policyholder, cardholder, or beneficiary.
Type of service used by doctors and hospitals to decide whether a patient needs inpatient hospital care or whether they can recover at home or in an outpatient area. Usually charged by the hour.
Any service received at a hospital or clinic that is not an inpatient status. Includes Emergence Room, Observation, and ancillary services.
A form used by hospitals to file insurance claims for medical services. Used when billing for hospital technical services.
Part of medicare that helps pay for doctor services, outpatient care, and other medical services not paid for by Medicare Part A.
Part of Medicare that usually referred to as Hospital Insurance, it helps pay for inpatient care in hospitals and hospices, as well as some skilled nursing costs.
Claim form used by doctors to file insurance claims for medical services. Used when billing for professional services.
Medicare Secondary Questionnaire
Hospital Billing (abv)
Professional Billing (abv)
After a patient is discharged from, the account status is changes from Open to
Hospital Account
A holding tank for accounts that we have identified has issues or needs follow up performed
Hospital Clinic System used by WVUH

Health Insurance Terms Crossword

Health Insurance Terms Crossword
Type
Crossword
Description

protection in return for periodic premium payments that provides reimbursement of expenses resulting from illness or injury
the sum of money paid at the time of medical service; it is a form of coinsurance
An established schedule of fees set for services performed by providers and paid by the patient
A provision of the Insurance Contract that requires the insured to pay a percentage of all eligible medical expenses that result from sickness or injury.
A term used in managed care for an approved referral
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.
An insurance term used when a primary care provider wants to send a patient to a specialist
periodic (monthly, quarterly, or annual) payment of a specific sum of money to an insurance company for which the insurer, in return, agrees to provide certain benefits
A request that an insured or the insured’s health care provider makes to the health plan to pay for a health care service provided to the insured.
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions.