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NHA CCMA Exam (2022/2023) with Certified Solutions

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Advance Beneficiary Notice (ABN) A form provided to the patient when the provider believes Medicare will probably not pay for services received Allowed Amount The maximum amount a third-party payer will pay for a particular procedure or service Copayment a small fixed fee paid by the patient at the time of an office visit Coinsurance a provision under which both the insured and the insurer share the covered losses, typically 80:20 deductible specific amount of money a patient must pay out of pocket before the insurance carrier begins paying Explanation of Benefits a form created by the insurance company to explain what charges were covered, denied, or need more documentation based on the claims submitted by the physician's office

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