Billing Frequently Asked Questions( FAQ)
• The amount a patient will pay after services have been completed and insurance has been applied to the amount.
Covered Services
• Specific services or supplies that your insurance reimburses.
CPT code
• CPT stands for Current Procedural Terminology code. This is a 5-digit standard code for how medical professionals document and report medical services and procedures. Insurance companies use CPT codes to help determine reimbursement amounts for practitioners. Using CPT codes enables healthcare providers and insurance companies to communicate and track billing more efficiently.
Deductible
• The agreed amount of money your benefit plan requires you to pay first before they will pay. The deductible is usually an annual amount. After the deductible has been met, you will pay any eligible expenses for the rest of the year.
Denial
• When an insurance company does not approve payment for a specific claim. In this case, the health insurer has decided not to pay for the procedure, test or prescription.
Dependent
• The person you carry on your insurance. Often this is a family member, such as a husband, wife or child.
Disallowed Amount
• The difference between total on the bill and the amount your insurance company covers.
Group Number
• A health plan ID number usually found on your insurance card.
Guarantor
• The person responsible for paying the bill.
Health Insurance Exchange
• The place to get insurance in Nevada if you currently do not have any.
HMO
• A type of insurance plan that requires enrolled patients to receive their healthcare from a specific group of providers, barring some emergency care. If you go
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