When a covered person authorizes his or her health benefits plan to directly pay a health care provider for covered services. Traditional health insurance pays benefits directly to the covered person. A method of payment where the insurance premium is deducted directly from an account at a financial institution on a monthly basis. The term also refers to the amount a health plan allows. The period of time a health plan will pay for covered benefits.
Benefit periods are usually one year.
They don't always reflect a calendar year. Providers are paid predetermined maximum allowances for covered health care services and agree to file claims on behalf of insureds. Case management - Coordination of services to help meet a patient's health care needs, usually when the patient has a condition which requires multiple services from multiple providers. This term is also used to refer to coordination of care during and after a hospital stay. Coinsurance - The dollar amount or percentage of the cost of medical care that a patient pays.