The nurse speaks with the spouse of a client on

A process completed before claims [ Choose ] submission in which claims are examined for accuracy and [ Choose ] completeness An organization that accepts claims from the provider and reformats the data and submits the claim. An online service which allows providers to look up patient’s insurance information. claims clearinghouse A percentage of the bill that patient must pay after meeting the deductible. audit The process of determining if a procedure or service is covered by the insurance. co-insurance deductible gatekeeper A set dollar amount the patient must provider network pay for each office visit. An order from a primary care provider for the patient to see a specialist or obtain services. A document explaining the allowed charge, amount reimbursed and patient’s financial responsibilities A set dollar amount that the copayment policyholder must pay before the eligibility insurance company starts to pay for services. EOB [ Choose ] precertification [ Choose ]

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