Exam (elaborations) CHAa 20237
New Patient - ANSWER Someone who has not received any services from the provider (or another provider of the same specialty or subspecialty who is a member of the same practice) within the past three years. Established Patient - ANSWER Patient who has seen a provider within the past three years. Referring Physician - ANSWER Physician who transfers care of a patient to another physician. Network - ANSWER A group of providers in a managed care organization. Participating Provider (PAR) - ANSWER Provider who agrees to provide medical services to a payer's policyholders according to a contract. Nonparticipating Provider (nonPAR) - ANSWER Provider who does not join a particular health plan. Out-of-Network - ANSWER Provider that does not have a participation agreement with a plan. If a patient does not have out-of-network benefits, the patient is responsible for the entire bill. Patient Information Form - ANSWER Form that includes a patient's personal, employment, and insurance company data.
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