Billing and Patient Financial Services Helpful Definitions
If you have any questions please call Norman Regional’s Patient Financial Services Department at 1-855-329-1834 or email at firstname.lastname@example.org.
- Beneficiary: A person who receives benefits of any insurance plan or policy.
- Claim: A request for payment for services submitted by the provider.
- Co-Insurance: A specified percentage of covered expenses which the insurance carrier requires the beneficiary to pay toward eligible medical bills.
- Co-Pay or Co-Payment: A specific set dollar amount contracted between the insurance company and the beneficiary to be paid prior to any services rendered.
- Covered Services: Services for which an insurance policy will pay.
- Deductible: A specified dollar amount of medical expenses which the beneficiary must pay before an insurance policy will pay.
- Explanation of Benefits (EOB): A statement from an insurance company showing the processing of a claim.
- Medically Necessary: Treatments of services that insurance policies will pay for as defined in the contract.
- Non-Covered Services: Services for which an insurance policy will not provide payment. These services are to be paid by the patient at the time of service.
- Pre-Certification/Authorization: A service specific requirement that your insurance company’s approval be obtained before a medical service is provided.
- Provider: A person or organization that provides medical services.