We're happy to provide you with advice and recommendations for getting your insurance information organized, please call the Client Accounts Team at 704-332-4834.
Authorization - Approval from the insurance plan for a covered service to be eligible for payment.
Benefit Period - The period of time during which incurred charges for covered services provided to a member must be incurred in order to be eligible for payment.
COBRA - The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires most employers with group health plans to offer employees the opportunity to continue temporarily their group health care coverage under their employer's plan if their coverage otherwise would cease due to termination, layoff, or other change in employment status (referred to as "qualifying events").
Copay - The fixed dollar amount that is due and payable by the member at the time a covered service is provided.
Coinsurance - The sharing of charges by an insurance plan and the member for covered services received by the member, usually stated as a percentage.
EOB (Explanation Of Benefits) - The description claim(s) processed by the insurance carrier. It typically includes the billed charges, payments, reason for denial(s) and member responsibility.
NCS (non covered service) - A service that is not covered by the insurance plan.
OOP - An out of pocket cost to the member.