Match the following
-An insurance company, third-party administrator, or self-insured health benefit plan that is contractually obligated to make payments on behalf of covered persons

Question

Quizplus · Accepted Answer

The term "payer" refers to an insurance company, third-party administrator, or self-insured health benefit plan that is contractually obligated to make payments on behalf of covered persons.

Answer: F
 The term "benefit plan" refers to an insurance plan that provides coverage for medical expenses.

Answer: H
 The term "covered services" refers to medical services that are included in an insurance plan's coverage.

Answer: J
 The term "covered person" refers to an individual who is covered by an insurance plan and eligible for benefits.

The other answer choices are:
A) copayment - a fixed out-of-pocket amount paid by a patient for a medical service
B) participating provider - a healthcare provider who has a contract with an insurance plan or network to provide services at discounted rates
C) capitation - a payment model where healthcare providers are paid a fixed amount per patient, regardless of the services provided
D) contracted services - medical services provided by healthcare providers who have a contract with an insurance plan or network
I) nonparticipating provider - a healthcare provider who does not have a contract with an insurance plan or network and may charge higher rates for services.

Match the Following -An Insurance Company, Third-Party Administrator, or Self-Insured Health Benefit Plan