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A copayment or copay (called a gap in Australian English) is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. It may be defined in an insurance policy and paid by an insured person each time a medical service is accessed.
An example: A brand offers a co-pay card giving patients the opportunity to save up to $20 off each prescription fill. A patient receives the co-pay card and visits their pharmacy. The patient provides his/her insurance card and co-pay card to the pharmacist. The pharmacist enters information into his/her pharmacy management system from both cards.
Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.
The decision strikes down an existing federal rule that allowed insurance plans to implement copay accumulator adjustment programs. New copay ruling could impact millions of prescription drug ...
Secondary capitation is a relationship arranged by a managed care organization between a physician and a secondary or specialist provider, such as an X-ray facility or ancillary facility such as a durable medical equipment supplier whose secondary provider is also paid capitation based on that PCP's enrolled membership.
The definition goes on to except rural telephone and electric cooperatives and any plan established or maintained pursuant to a collective bargaining agreement. The benefits included as welfare plan benefits are broadly described and wide-ranging. Virtually any type of health, medical, sickness, or disability benefits will fall into this ...
Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among many individuals.
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance , self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
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