Is the responsible party the same as the patient?
Is the responsible party the same as the patient?
Responsible Party – Person responsible for paying the patient portion of the billed services and receives statements. Policy Holder – Person responsible for the patient’s insurance.
What’s a responsible party?
The “responsible party” is the individual or entity that controls, manages, or directs the entity and the disposition of the entity’s funds and assets, unlike a nominee, who is given little or no authority over the entity’s assets.
Who is responsible for paying amounts not covered by insurance called the guarantor of the account?
Grievance: A complaint about the way health care service, process or payment were handled. Guarantor: The person responsible for payment of rendered services. The guarantor is customarily the person bringing the patient in for treatment. This person is not necessarily the same as the subscriber.
Which is the fixed amount the patient pays each time?
42 Cards in this Set
| Which means that the patient and/or insured has authorized the payer to reimburse the provider directly? | assignment of benefits |
|---|---|
| Which is the fixed amount patients pay each time they receive health care services? | copayment |
What do you call the determination that a specific treatment is medically necessary and covered by the insurance policy?
Medical necessity determination. A specific type of coverage determination about whether a medical item or service, which is a covered benefit, is medically necessary for an individual patient’s circumstances, and thus a covered benefit. Typically, this determination is made by the insurer.
Who is considered the guarantor?
Guarantor: The person who ultimately accepts financial responsibility to pay the patient’s bill. In most cases it is the adult patient receiving the service. If the patient is a child, the responsible party may be the child’s parent or legal guardian.
