Private health insurance is coverage by a health plan provided by an employer or purchased by an individual from a private health insurance company.
Preadmission certification is preapproval by a health insurance company or employer-sponsored plan for an individual???s admittance to a hospital. If precertification is not obtained for a non-emergency procedure, the insurance provider may pay for some of the services received or may not pay for any of the services.
HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996. Known primarily as the health privacy law, it provides federal protections for personal health information held by covered entities and gives patients a large number of rights as far as how that information is shared.The law also protects an individual’s ability […]
Group health insurance is insurance coverage offered through an employer or other entity that covers all individuals in the group.
Coinsurance is the money a patient must pay after a deductible has been paid. It is generally specified by a percentage of a retail price. For example, an employee may pay 10 percent for a service while the insurance company or employer pays 90 percent. Many drug companies also use coinsurance in part to make […]
An outpatient is an individual who receives health care services on an outpatient basis, meaning the person does not stay overnight in a hospital or inpatient facility. These services can include diagnosis, treatment and surgery.
The out-of-pocket maximum or limit is the maximum amount a person will have to pay for covered services in a year. Generally, this includes copayments, coinsurance and deductibles, though it may vary from insurance plan to insurance plan.