Terms
Co-payment - a fixed amount or percentage of an approved amount that the member must pay the provider for a covered service. Student Resources states that you are responsible for a $15 co-pay per day when you have charges that are incurred at PUSH and billed to insurance.
EOB (Explanation of Benefit) – a statement from an insurance company that details what services have been covered and what may be the patient’s responsibility.
Guarantor/Policyholder – the person who is the primary holder of an insurance policy. Dependents may be added to their policy within 30 days of a qualifying event.
Pre-existing conditions provision - A health insurance policy provision stating that benefits will not be paid for any illness and/or condition that existed prior to one becoming an insured under the particular health plan in question, until the insured has been covered under the policy for a specified period.
Preventive care - services provided for health maintenance, such as routine health exams and tests.
Procedure code – a series of numeric or alphanumeric characters and corresponding descriptions for each medical service.
Provider – person or facility providing services or supplies related to medical care.
