||A hospital employee paid to assist and advocate for patients who encounter problems with their care.
||A person or organization which pays the hospital for services rendered to patients. This can be the patient and/or third parties such as Medicare or other private insurance plans.
||A financial agreement between a patient and a financial counselor or other representative of the provider’s office prior to initiating treatment. Individual terms apply at the discretion of the practice.
||A determination made by an insurance carrier prior to the provision of services that the services are medically necessary and covered under the benefit plan.
|Preferred Provider Organization (PPO)
||An insurance organization that contracts with medical care providers to provide health care services to their members at lower-than-usual fees in return for prompt payment. If a patient wants to receive services outside the PPO network, the PPO will limit coverage.
||The amount an insured individual pays to purchase insurance and keep it active.
||A third-party payer identified as having primary responsibility for payment of charges.
||An individual or institution which gives medical care. Institutional providers include a hospital, skilled nursing facility and intermediate care facility. Individual providers include individuals (physicians, dentists, etc.) whose primary activity is the provision of health care to individuals.