Patient Billing

Glossary of Terms

This glossary of terms will help you understand some of the typical terms used in the billing process.

Co-Insurance or Co-pays
Amount designated by the insurance company as the responsibility of the insured, usually reported as a percentage of the total amount paid.

Coordination of Benefits (COB) Rules
Rules that determine which insurance is to be billed first (primary) for services when patient is covered by more than one carrier. State and federal guidelines apply.

Deductible
Amount designated by the insurance company as the patient's responsibility, reported as an amount that must be paid before insurance benefits begin.
    

Explanation of Benefits (EOB)
Itemized statement from your insurance company detailing which services are covered.

Medicare - Part A
Medicare hospital insurance covering care in the hospital, at any skilled nursing facility and from a home health agency.

Medicare - Part B
Medicare supplementary medical insurance covering outpatient services from physicians, surgeons or any professional technicians.

Primary Insurance
Designation given to the insurer that has first priority for payment of a claim.

Secondary Insurance
Designation given to the insurer that has second priority for payment of a claim. Applies after the primary insurance pays or rejects an insurance claim.