HEALTH INSURANCE KEY TERMS 2025.
Everything you need to pass—nothing you don’t!
Adjustment - Answer: credit entry made on an account to decrease a balance owed to the
medical office; may be due to insurance, professional discounts, write-offs, or to correct
bookkeeping errors.
Allowed Amount - Answer: the maximum amount an insurer will pay for any given service.
Authorization - Answer: to release medical information (release of medical information
form)
Claim 1500 Form - Answer: he standard claim form designed by the Centers for Medicare
and Medicaid Services to submit physician services for third-party (insurance companies)
payment; the standard paper claim form to bill Medicare Fee-For-Service (FFS) Contractors
when a paper claim is allowed.
Coding - Answer: establish a way to communicate numerically or alphanumerically with
carriers and at the same time provide a means to collect data for national and international
purposes.
Coinsurance - Answer: a percentage that a patient is responsible for paying for each
service after the deductible has been met.
Copayment - Answer: A flat rate that is due at the time of service.
CPT - Answer: a numerical listing of procedures performed in medical practice; a
standardized identification of procedures. Published by the American Medical Association.
Deductible - Answer: an amount to be paid before insurance will pay.
APPHIA – Crafted with Care and Precision for Academic Excellence. 1
Everything you need to pass—nothing you don’t!
Adjustment - Answer: credit entry made on an account to decrease a balance owed to the
medical office; may be due to insurance, professional discounts, write-offs, or to correct
bookkeeping errors.
Allowed Amount - Answer: the maximum amount an insurer will pay for any given service.
Authorization - Answer: to release medical information (release of medical information
form)
Claim 1500 Form - Answer: he standard claim form designed by the Centers for Medicare
and Medicaid Services to submit physician services for third-party (insurance companies)
payment; the standard paper claim form to bill Medicare Fee-For-Service (FFS) Contractors
when a paper claim is allowed.
Coding - Answer: establish a way to communicate numerically or alphanumerically with
carriers and at the same time provide a means to collect data for national and international
purposes.
Coinsurance - Answer: a percentage that a patient is responsible for paying for each
service after the deductible has been met.
Copayment - Answer: A flat rate that is due at the time of service.
CPT - Answer: a numerical listing of procedures performed in medical practice; a
standardized identification of procedures. Published by the American Medical Association.
Deductible - Answer: an amount to be paid before insurance will pay.
APPHIA – Crafted with Care and Precision for Academic Excellence. 1
