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Health Insurance Terms B

Friday, December 21, 2007
Posted by insurance terms

Base Capitation
The total amount which covers the cost of health care per person, minus any mental health or substance abuse services, pharmacy, and administrative charges.

Basic Hospital Expense Insurance
Hospital coverage providing benefits for room and board and miscellaneous hospital expenses for a specified number of days during hospital confinement.

Bed Days/1,000
The number of inpatient hospital days per 1,000 members of the health plan.

Benefit Levels
The maximum amount a person is entitled to receive for a particular service or services as spelled out in the contract with a health plan or insurer.

Benefit Package
A description of what services the insurer or health plan offers to those covered under the terms of a health insurance contract.

Benefit Period
Defines the period during which a Medicare beneficiary is eligible for Part A benefits. A benefit period is 90 days which begins the day the patient is admitted to a hospital and ends when the individual has not been hospitalized for a period of 60 consecutive days. (H)

Billed Claims
The amounts submitted by a health care provider for services provided to a covered individual.

Binding Receipt
See Conditional Binding Receipt.

Birthday Rule
One method of determining which parent's medical coverage will be primary for dependent children: the parent whose birthday falls earliest in the year will be considered as having the primary plan.

Blanket Insurance
A contract of Health Insurance that covers all of a class of persons not individually identified in the contract.

Blanket Medical Expense
A policy or provision in a Health Insurance contract that pays all medical costs, including hospitalization, drugs, and treatments, without limitation on any item except possibly for a maximum aggregate benefit under the policy. It is often written with an initial deductible amount.

Blue Cross
Blue Cross plans are nonprofit hospital expense prepayment plans designed primarily to provide benefits for hospitalization coverage, with certain restrictions on the type of accommodations to be used.

Blue Plan
A generic designation for those companies, usually writing a service rather than a reimbursement contract, who are authorized to use the designation Blue Cross or Blue Shield and the insignia of either.
Blue Shield
Blue Shield plans are prepayment plans offered by voluntary nonprofit organizations covering medical and surgical expenses.

Board Certified
A physician or other professional who has passed an examination which certifies him or her as a specialist in a particular medical area.

Board Eligible
A professional person or physician who is eligible to take a specialty examination.

Business Overhead Expense
A disability income policy which indemnifies the business for certain overhead expenses incurred when the business owner is totally disabled.

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