Billing Term Glossary

/Billing Term Glossary

Tertiary Insurance

The insurance organization with third responsibility for paying eligible insurance expenses for your medical service (after you have paid your deductible, co-payments, etc.). This insurance (if you have it) [...]

Statement

A record of account status sent to patients monthly to advise of the previous period's transactions and activity on the account.

Secondary Insurance

The insurance organization with second responsibility for paying eligible insurance expenses for your medical service (after you have paid your deductible, co-payments, etc.). This insurance (if you have it) [...]

Primary Insurance

The insurance organization with first responsibility for paying eligible insurance expenses for your medical service (after you have paid your deductible, co-payments, etc.). Your secondary or other insurance (if [...]

Pre-Authorization/Pre-Certification

Requirement of your insurance company to determine medical necessity for services rendered. Pre-certification does not guarantee benefits for payment. Benefits are based on policy provisions in force at the [...]

Participating Health Care Provider

A health care provider who contracts with an insurance organization to accept patients and receive the insurance organizations approved amount on all claims

Non-Participating Health Care Provider

A health care provider who isn't under contract with an insurance organization to accept patients and receive the insurance organizations approved amount on all claims. (You pay the difference [...]

Non-covered Services

A service not covered under the limits of the patient's health insurance contract. These amounts are the patient's responsibility to pay. Patients should direct questions about coverage to their [...]

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