Billing Statement
A summary of current activity on an account.
Claim
Information billed to the insurance company for services provided.
Co-payment or Coinsurance
The balance due by the policyholder as determined by the insurance company.
Deductible
Amount the policyholder needs to pay for covered health services before a health plan will begin to pay benefits. Usually, a new deductible is met each calendar year.
EOB (Explanation of Benefits)
A detailed explanation from the insurance company that identifies the amount due for services provided. This includes any payments made by the insurance company and any listed co-payment, coinsurance, or deductible due from the policyholder.
Financial Assistance
The Financial Assistance Program is intended patients who cannot afford or do not qualify for health insurance, and/or have very limited financial resources, or who have incurred sizable medical bills that are beyond their ability to pay.
Guarantor
The person responsible for paying the bill.
Payment Arrangements
A formal payment plan set up between a patient and a Providence customer service representative when payment cannot be made in full.
Payor
A third-party entity (commercial or government insurance carriers) that pays medical claims.
Primary Insurance
Designation given to the insurer that your claim will be submitted to first, for payment of services you received.
Prior Authorization/Pre-Certification
A formal approval obtained from the insurance company prior to delivery of medical services. Many insurance companies require prior authorization or pre-certification for specific medical services.
Subscriber
The person who holds and/or is responsible for the medical insurance policy.
Secondary Insurance
Designation given to the insurer that your claim will be submitted to second, for payment of services you received.
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