Usually charged by the hour. Oncology - Charges for treating cancer and related diseases. Operating Room - A hospital or clinic area where surgeries are done. Other Room and Board - Any extra charges that cannot be included in routine room and board charges.
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Out-of-Network Provider - A doctor or other healthcare provider who is not part of an insurance plan's doctor or hospital network. Same as non-participating provider. Out-of-Pocket Costs - Costs you must pay because Medicare or other insurance does not cover them. Outpatient OP - Patient who does not need to stay overnight in a hospital.
Outpatient services include lab tests, x -rays, and some surgeries. Outpatient Service - A service you receive in one day at a hospital or clinic without staying overnight. Over-the-Counter Drug - Drugs not needing a prescription that you buy at a pharmacy or drug store. P Paid to Provider - Amount the insurance company pays your medical provider. Paid to You - Amount the insurance company pays you or your guarantor. Participating Provider - A doctor or hospital that agrees to accept your insurance payment for covered services as payment in full, minus your deductibles, co-pays and coinsurance amounts.
Patient Amount Due - The amount charged by your doctor or hospital that you have to pay. Patient Type - A way to classify patients - -outpatient, inpatient, etc. Pay This Amount -How much of your bill you have to pay. Per Diem - Charged or paid by the day. Physician - Person licensed to practice medicine. Physician Extenders - Also called mid -level service providers. Physician Practice - A group of doctors, nurses, and physician assistants who work together. Physician Practice Management - Non -physician staff hired to manage the business aspects of a physician practice.
These staff include billing staff, medical records staff, receptionists, lab and X -ray technicians, human resources staff, and accounting staff. Point-of-Service Plan POS - An insurance plan that allows you to choose doctors and hospitals without having to first get a referral from your primary care doctor. Policy Number - A number that your insurance company gives you to identify your contract. Pre-Admission Approval or Certification - An agreement by your insurance company to pay for your medical treatment. Doctors and hospitals ask your insurance company for this approval before providing your medical treatment.
Pre -Existing Condition - A health condition or medical problem that you already have before you sign up to receive insurance. Some health insurers may not pay for health conditions you already have.
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Prepayments - Money you pay before getting medical care; also referred to as preadmission deposits. Prevailing Charge - A billing charge that is commonly made by doctors in a specific region or community. Your insurance company determines this charge. Primary Insurance Company - The insurance company responsible for paying your claim first. If you have another insurance company, it is referred to as the Secondary Insurance Company.
Private Room Deluxe - A more expensive hospital room than those available to other patients. You may have to pay extra for this type of room if it is not a medical necessity. Provider Contract Discount - A part of your bill that your doctor or hospital must write off not charge you because of billing agreements with your insurance company. Provider Name, Address, and Phone - Name and address of the doctor or hospital submitting your bill.
R Radiology - X -rays used to identify and diagnose medical problems. Recovery Room - A special room where you are taken after surgery to recover before being sent home or to your hospital room. Referral - Approval needed for care beyond that provided by your primary care doctor or hospital.
For example, managed care plans usually require referrals from your primary care doctor to see specialists or for special procedures. Release of Information - A signed statement from patients or guarantors that allows doctors and hospitals to release medical information so that insurance companies can pay claims. Renal Dialysis - Removal of wastes from the blood. Normally the kidneys would remove these wastes if they were functioning properly.
Respiratory Therapy - Giving oxygen and drugs through breathing, as well as other therapies that measure inhaled and exhaled gases and blood samples.
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Responsible Party - The person s responsible for paying your hospital bill - -usually referred to as the guarantor. Revenue Code - A billing code used to name a specific room, service X -ray, laboratory , or billing sum. Room and Board Private - Routine charges for a room with one bed. Room and Board Semiprivate - Routine charges for a room with two beds.
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S Same-Day Surgery - Outpatient surgery. Secondary Insurance - Extra insurance that may pay some charges not paid by your primary insurance company. Whether payment is made depends on your insurance benefits, your coverage, and your benefit coordination.
Service Area - Geographic area where your insurance plan enrolls members. In an HMO, it is also the area served by your doctor network and hospitals. Service Begin Date - The date your medical services or treatment began. Service Code - A code describing medical services you received.
Service End Date - The date your medical services or treatment ended. Skilled Nursing Facility - An inpatient facility in which patients who do not need acute care are given nursing care or other therapy.
Source of Admission - The source of your admission—referral, transfer, emergency room, etc. Specialist - A doctor who specializes in treating certain parts of the body or specific medical conditions. For example, cardiologists only treat patients with heart problems. Statement Covers Period - The date your services or treatment begin and end.
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Doctors and hospitals get an ID from each insurance company to whom they send claims using the computer. Supplemental Insurance Company - An additional insurance policy that handles claims for deductible and coinsurance reimbursement. Swing Bed - Bed for a patient who receives skilled nursing care in a non -skilled nursing facility.
Lack of major medical coverage or other minimum essential coverage may result in an additional payment with your taxes. You are now leaving www. This link will be taking you away from the www. Why Hospital Insurance? Nearly 34 million patients are admitted to the hospital each year. Explore Your Options.
Plan design and availability vary by state. Find out which ones are available where you live. View Plans.
Hospital insurance can benefit you and your family in many ways Although you may find the standard of care in the NHS very high; the desire for convenience and comfort may mean that you prefer to use the private sector. Once you have decided to go private — you will need to choose where and when you would like to get treated. See our How to Choose a Private Hospital guide for more information. You may be able to access private healthcare through: Private health insurance bought by yourself. Private health insurance provided by your employer.
By taking a medical loan — some hospitals provide loans to help you to pay for your treatment. How to find a specialist Your GP may be able to recommend a specialist but you can also research the web to find someone suitable. Many hospitals provide specialist services for particular health conditions, for example some may specialise in heart conditions while others specialise in nose and throat.