1
Care that is ______ in nature is considered maintenance care and not due to a diagnosis of illness or injury.
2
Under the ACA, all health plans must cover _________ benefits.
3
What member must pay (ie. deductible, copay, etc)
4
A specific service or condition that is listed as Not Covered in the contract
5
A resource that contains step by step instructions for a process.
6
the minimum amount of time between like services in order for the services to be covered
7
a professional or facility that provides medical, dental, or prescription services to a member
8
A group of providers that have signed a contract
9
An employee or their dependent that is enrolled on a plan
10
Benefits may have __________ for services in a specified time frame. Once met, services are denied.
11
____-Insured groups pay the insurance carrier to handle everything, including paying claims
12
a fixed dollar amount that the patient must pay upfront
13
The employer that has purchased a product from Premera
14
___-Insured Groups pay for their own claims
15
Out of Network
16
In Network
17
Participating
18
Primary Care Provider
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