Glossary Of Billing Terms

Account: Your charges for a medical visit

Account number: Number you’re given by your doctor or hospital for a medical visit

Amount Not Covered: What your insurance company does not pay. It includes deductibles, coinsurances, and charges for non-covered services.

Applied to Deductible: Portion of your bill, as defined by your insurance company, that you owe your doctor or hospital

Assignment: An agreement you sign that allows your insurance to pay the doctor or hospital directly.

Assignment of Benefits: When insurance payments are sent directly to your doctor or hospital.

Balance: The amount owed to your doctor or the hospital indicated on the billing statement.

Claim: Your medical bill that is sent to an insurance company for processing.

Coinsurance: The cost sharing part of your bill that you have to pay.

Collection Agency: A business that collects money for unpaid bills.

Co-payment: A cost sharing part of your bill that is your responsibility to pay. Also known as co-pay.

Deductible: How much cost sharing that you must pay for medical services often before your insurance company starts to pay

Estimated Insurance: Estimated cost paid by your insurance company.

Estimated Amount Due: How much the doctor or hospital estimates you or your insurance company owes.

Financial Responsibility: How much of your bill you have to pay

Network: A group of doctors, hospitals, pharmacies, and other health care experts hired by a health plan to take care of its members.

Non-covered Services: A service not covered under the limits of your health insurance contract. These amounts are the your responsibility to pay. Any questions about coverage should be directed to your health plan.

Participating Provider: When the doctor or hospital agrees to accept your insurance payment for covered services as payment in full, minus your deductibles, copays and coinsurance amounts.

Proof of Health Insurance: A valid insurance card including the address where claims are to be filed.

Self-pay Patient: A person who has no insurance. This patient is financially responsible for all charges for their medical treatment. Self-pay patients must pay the entire balance in full and may be asked to do so at the time of service.

Service: Medical services or treatment

Time of Service: Your appointment time or time that you receive medical services.

Total Charges: Total cost of your medical services

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