||A term describing a patient’s ability to self-refer for specialty care. Open access arrangements allow a member to see a participating provider without a referral from another doctor.
||The amount the patient is required to personally pay for relating to co-payments and deductibles.
||The total amount of out-of pocket money the patient must pay for health care in a calendar year. Once this limit is reached, the patient is then covered at 100% for all health services received during the rest of the year.
||A patient, not officially admitted into a hospital, who receives hospital care without occupying a hospital bed or receiving room, board, or general care.
||Uncollected or yet to be paid.