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Claiming a crossword (Insurance)

Horizontales
Health insurance for children 0-17 who's families earn above the threshold for medicaid but not enough for private insurance.
Amount a patient must pay before insurance coverage begins
10 digit code used to identify providers
Private health plan that requires a PCP. Can see out of network specialists with a referral only.
Private health plan that only covers in network care but networks are generally larger than HMO. May or may not require a PCP.
Act that allows providers to manually submit claims on a paper form rather than electronically for special reasons
Government health insurance for active military service personnel
A system that allows data to be exchanged electronically which results in faster payment
Individual paying for insurance
A notice given to a patient by the insurance company detailing what benefits were received and billed
Government funded insurance plan for citizens 65 years of age and older. Contains parts A-D.
A company that provides scrubbing services for claims before submission to insurance
Allows employees injured in the workplace due to a work-related task to be covered, injury must be reported and filed
Plans sold directly by health insurance company or through a third party broker
Private health insurance plan which requires a PCP. You can see out of network providers but a referral is required.
Verticales
A way to determine the primary coverage when a patient is double covered
Health insurance for veterans who were injured or killed in the line of duty. Covers veterans, spouses and dependents. Also called Civilian health and medical plan
A fixed percentage paid by the patient after the deductible has been met
Reviewing services prior to provision to determine medical necessity
Additions to health insurance that include dental, vision, gap, and critical illness
Law passed in 2010 to make health insurance more affordable. Prevents health insurance from denying coverage of pre-existing condition
Plans sold on government exchanges.
Claims submitted electronically
Standard form used by offices to file claims
Stands for Primary Care Physician. A PCP is the main provider for the insured but can refer to other specialists when required (acts as a gatekeeper).
Private insurance plan that requires a PCP. Generally regarded as the cheapest plan with no coverage for out of network care.
Allows claims to be tracked faster and status to be checked regularly
A fixed amount paid by a patient for a specified visit
Government funded health insurance for lower income families and individuals.
Private health plan with most freedom. Do not need a referral to see out of network but it does cost more. Most expensive plan.