Fee Schedule Gatekeeper Precertification Carrier Medicare Non-Par Provider Out-of- Pocket Maximum Co- payment Prescription Drug Coverage HSA Preexisting Condition UCR Deductible Coinsurance CMS- 1500 Affordable Care Act (ACA) Service Area Explanation of Benefits (EOB) Beneficiary Waiver Premium Effective Date Specialist Subscriber TPA Group Insurance Assignment of Benefits (AOB) Premiums Allowed Amount Participating Provider FSA Medically Necessary HIPAA Coordination of Benefits (COB) Fee Schedule Gatekeeper Precertification Carrier Medicare Non-Par Provider Out-of- Pocket Maximum Co- payment Prescription Drug Coverage HSA Preexisting Condition UCR Deductible Coinsurance CMS- 1500 Affordable Care Act (ACA) Service Area Explanation of Benefits (EOB) Beneficiary Waiver Premium Effective Date Specialist Subscriber TPA Group Insurance Assignment of Benefits (AOB) Premiums Allowed Amount Participating Provider FSA Medically Necessary HIPAA Coordination of Benefits (COB)
(Print)
Fee Schedule
Gatekeeper
Precertification
Carrier
Medicare
Non-Par Provider
Out-of-Pocket Maximum
Co-payment
Prescription Drug Coverage
HSA
Preexisting Condition
UCR
Deductible
Coinsurance
CMS-1500
Affordable Care Act
(ACA)
Service Area
Explanation of Benefits
(EOB)
Beneficiary
Waiver
Premium
Effective Date
Specialist
Subscriber
TPA
Group Insurance
Assignment of Benefits
(AOB)
Premiums
Allowed Amount
Participating Provider
FSA
Medically Necessary
HIPAA
Coordination of Benefits
(COB)
