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People from US normally acquire their medical insurance through their employer. An employer /company signs up for a particular health insurance plan, offers the plan to its employee and allows the employee to decide whether he/she wants to sign up. (Most employees do sign up and its often one of the firs

The role, structure and functions

How medical Insurance works

Types of medical insurance

 

WHAT IS MEDICAL BILLING?

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MEDICAL BILLING FUNCTION

People from US normally acquire their medical insurance through their employer. An employer /company signs up for a particular health insurance plan..

 

 

 

 

MEDICAL INSURANCE PLANS

 

Types of Medical insurance can be basically placed in 6 categories:

  1. Deductible
  2. PPO's
  3. HMO's
  4. Medicare
  5. Medicaid

 

 

1. DEDUCTIBLE:


This is the oldest type of medical insurance .it use to be the only one offered. With a deductible plan, the insured person has a stipulated amount of money he/she must pay before the plan's benefits go into effect. This pre-determined amount is called a deductible. Deductible amounts vary from plan to plan. A rule of thumb is that the higher the   deductible amount, the lower the monthly premiums are.

 

After a patient reaches his/her deductible, the health insurance company begins paying for a portion of incurred charges. And, the patient pays for the remainders .This is called the coinsurance and most plans offer payment structures in the following manner:

 

90% / 10%
80% / 20%
70% / 30%
60% / 40%

 

In health insurance lingo , this is called 90,10 or 80,20 or 70,30 . If a patient's health insurance is 80/20, then the insurance company pays 80% and balance 20% out of his/her pocket.