This is the process by which a health insurance company determines if it should be the primary or secondary payer of medical claims for a patient who has coverage from more than one health insurance p [..]

An office visit is the amount you pay when you see the doctor or dentist for routine care. Examples for $100 office visit: If the plan's office visit is $25, then you pay $25. If the p [..]

PPO PPO means "Preferred Provider Organization." Like the name implies, with a PPO plan you'll need to get your medical care from doctors or hospitals on the insurance company's li [..]

A method of classifying sick or injured patients according to the severity of their conditions in order to ensure that medical facilities and staff are most effectively utilized.

The availability of medical care. The quality of one's access to medical care is determined by location, transportation options, and the type of medical care facilities available in the area, etc [..]

For health insurance purposes, an accident is an unforeseen, unexpected and unintended event resulting in bodily injury.

The period of time during which an insured person incurs eligible medical expenses toward the satisfaction of a deductible.

Most group health insurance policies state that if an employee is not "actively-at-work" on the day the policy goes into effect, the coverage will not begin until the employee returns to wor [..]

The actual dollar amount charged by a physician or other provider for medical services rendered, as distinguished from the allowable charge.

A person professionally trained in the mathematical and statistical aspects of the insurance industry. Actuaries frequently calculate premium rates, reserves and dividends and assist in estimating t [..]