Emergency Room Care Allowed Amount Balance Billing Emergency Medical Transportation Health Insurance Co- payment Reconstructive Surgery Non- Preferred Provider Appeal Specialist Preauthorization Medically Necessary Physician Services Network Out-of- pocket Limit Prescription Drug Coverage Durable Medical Equipment Hospital Outpatient Care In-network Co- insurance Emergency Services Provider In-network Co- payment Co- insurance Home Health Care Emergency Room Care Allowed Amount Balance Billing Emergency Medical Transportation Health Insurance Co- payment Reconstructive Surgery Non- Preferred Provider Appeal Specialist Preauthorization Medically Necessary Physician Services Network Out-of- pocket Limit Prescription Drug Coverage Durable Medical Equipment Hospital Outpatient Care In-network Co- insurance Emergency Services Provider In-network Co- payment Co- insurance Home Health Care
(Print)
B-Emergency Room Care
N-Allowed
Amount
O-Balance Billing
B-Emergency Medical Transportation
O-Health Insurance
G-Co-payment
O-Reconstructive Surgery
B-Non-Preferred Provider
G-Appeal
B-Specialist
N-Preauthorization
I-Medically Necessary
B-Physician Services
N-Network
G-Out-of-pocket Limit
O-Prescription Drug Coverage
I-Durable Medical Equipment
I-Hospital Outpatient Care
G-In-network Co-insurance
O-Emergency Services
N-Provider
G-In-network Co-payment
I-Co-insurance
I-Home Health Care
