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Frequently Used Terms

Here is a list of glossary terms used throughout our site.

  • Claim: A request for payment that you or your health care provider submits to your health insurer for services.
  • Copay:  The set amount you must pay for a health care service.
  • Deductible: The amount you must pay for health care before your insurance benefits take effect.
  • Coinsurance:  The percentage of health care costs you must pay once your insurer covers their share. Coinsurance typically goes into effect once the deductible has been reached.
  • Explanation of Benefits (EOB): An explanation of benefits is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf and what portion of the services will be the patient’s responsibility. This statement is not a bill.
  • Facility Service Fees: Fees for the use of the health care facility, equipment, supplies, and staff supporting your provider.
  • Fee for Service: A method in which doctors and other health care providers are paid for each service performed. Examples includes tests and office visits.
  • Hospital Outpatient Care: Care received in the hospital that usually does not require an overnight stay.
  • Inpatient Care: Care you receive when you are admitted as an inpatient to a health care facility, like a hospital or skilled nursing facility.
  • Misc:  This may be listed on your bill and refers to other reasons you may owe a balance, such as a service not being covered by your insurer.
  • Out-of-pocket: Expenses for medical care that aren't reimbursed by insurance.
  • Physician Services: Health care services a licensed medical physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) provides or coordinates.
  • Professional Service Fees: Fees related to the time your caregiver/physician spends treating you during your visit.
  • Underinsured: The patient has some level of insurance or third-party assistance but still has out-of-pocket expenses that exceed his/her financial abilities.
  • Uninsured: The patient has no level of insurance or third-party assistance or has lost their insurance due to a life-changing event such as loss of a job or some other circumstance that has caused an interruption in meeting payment obligations.