MAP 205 Crossword

To treat with cruelty or violence
Your doctor, provider, or supplier agrees to accept the Medicare-approved amount as full payment for covered services
Process of review that healthcare organizations participate in to demostrate the ability to meet predetermined criteria and standards of accreditation established by a professional accrediting agency
The determination of the insurers payment or financial responsibility after the members insurance benefits is applied to a medical claim
The maximum amount that an insurer will consider to pay for a service, including any amount that the patient will be responsible for paying
A request for your health insurance marketplace to review a decision that denies a benefit or payment
A form of alternative dispute resolution, is a technique for the resolution of disputes outside the courts
An arrangement by which a patient requests that his or her health insurance benefit payments be made directly to a designated person or facility
A person or group that receives benefits, profits, or advantages
The health plan of the parent whose birthday comes first in the calendar year is designated as the primary plan
Payment arrangement for health care service providers such as physicians or nurse practitioners
A comprehensive listing of items billable to a hospital patient or a patients health insurance provider
A medical claim that has no errors or omissions
Companies that function as intermediaries who forward claims information from healthcare providers to insurance payers
a type of insurance in which the insured pays a share of the payment made against a claim.
The state of keeping or being kept secret or private.
The process by which the patient and his/her physician-led care team are cooperatively involved in ongoing health care management toward the shared goal
Refers to qualifying for both medicare and medicaid
A payment made by beneficiary in addition to that made by the insurer
A specified amount of money that the insured must pay before an insurance company will pay a claim
The alteration by an insurer or other third-party of service codes for physicians or other health care providers
Payment model where no service are unbundled and paid for seperately
complete listing of fees used by medicare to pay doctors or other providers/suppliers.
wrongful or criminal deception intended to result in financial or personal gain.
A provision that may be incorporated in a physicians contract with managed care organizations
term used to describe the person in charge of a patients treatment
the person legally responsible for charges incurred
the process of taking legal action
Is a type of errors and omissions (E&O) coverage. It protects physicians and other healthcare professionals against claims alleging their negligent acts caused injury to patients
health care services that a physician, exercising prudent clinical judgment, would provide to a patient
A person or group in whose name an insurance policy is held.
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary