Financial Glossary

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Term Definition
Open Access 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.
Out-of-Pocket Expenses The amount the patient is required to personally pay for relating to co-payments and deductibles.
Out-of-Pocket Limit 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.
Outpatient A patient, not officially admitted into a hospital, who receives hospital care without occupying a hospital bed or receiving room, board, or general care.
Outstanding Uncollected or yet to be paid.