accreditation
accredited
accumulation period
administrative services only
admitting physician
admitting privileges
after care
agent of record
ambulatory care
ancillary services
any willing provider laws
appeal
ASO
assignment of benefits
attachment
beneficiary
benefit
benefit cap
board certified
broker
capitation
care plan
case management
case manager
centers of excellence
certificate of coverage
claim
clinical practice guidelines
co-insurance
co-pay
co-payment
COB
COBRA
concurrent review
consolidated omnibus budget reconciliation act
contract year
coordinated care
coordination of benefits
cost sharing
covered benefit
covered charges/expenses
covered person
CPT
credentialing
creditable coverage
critical access hospital
current procedural terminology
custodial care
deductible
deductible carry over credit
defensive medicine
denial of claim
dependent
designated facility
diagnostic related group
discharge planning
disenroll
DRG
EAPs
effective date
eligible dependent
eligible expenses
employee assistance programs
enrollee
EOB
episode of care
evidence of insurability
exclusion period
exclusions and limitations
explanation of benefits
fee schedule
fee-for-service
first dollar coverage
flexible benefit plan
flexible spending account
formulary
free-look period
FSA
full-time student
gag rule laws
gatekeeper
general agent
grievance
group health plan
guaranteed issue
HCFA Common Procedure Coding System
HCPCS
HDHP
health care provider
health employer data and information set
health insurance portability &amp; accountability act
health maintenance organization
health reimbursement arrangement
health savings account
HEDIS
high deductible health plan
HIPAA
HMO
home health care
hospice care
hospital care
hospital-surgical coverage
HRA
HSA
impaired risk
incurral date
indemnity health plan
independent practice associations
inpatient care
insured
international classification of diseases, 9th revision, clinical modification icd-9-cm
IPA
lapse
lifetime maximum
limited policy
major medical
managed care
master policy
medicaid
medical necessity
medical savings account
medically necessary
medicare
medicare supplement
medigap
misrepresentation
morbidity
MSA
NAIC
national association of insurance commissioners
national committee for quality assurance
national drug code
NCQA
NDC
network
network provider
noncancellable policy
nonrenewable
open enrollment
out-of-network
out-of-plan
out-of-pocket costs
out-of-pocket maximum
participating provider
PCP
permanent insurance
policy
policy year
policyholder
portability
PPO
pre-admission review
pre-admission testing
pre-authorization
pre-certification
pre-existing condition
preferred provider organization
pregnancy care
premium
preventive care
primary care physician
prior authorization
provider
qualifying event
R&C charge
reasonable and customary
referral
renewal
rider
risk
schedule of benefits and exclusions
second surgical opinion
self administered
self-insured
service area
short-term medical insurance
SIC
skilled nursing facility
special benefit networks
staff model
standard industrial classification
state insurance department
state-mandated benefits
stop-loss provisions
third-party payer
underwriting
urgent care
usual and customary charge
utilization review
waiting period
well-baby care
wellness office visit
workers compensation
