This is the amount an insured patient must pay out-of-pocket for medical expenses before the insurance plan begins to pay. Deductibles range in amount according to the terms of the specific policy.

This is the amount considered by a health insurance provider to be reasonable when deciding on a reimbursement rate.

This is the percentage of coverage that a patient is responsible for paying, after insurance has paid their agreed-on portion, as stated in the patient's policy. Co-insurance rates vary greatly depending on the health plan, and may also be subject to your deductible. Keep in mind that co-pay is an entirely separate term from co-insurance. A co-pay is a set, out-of-pocket expense the patient pays, often for an appointment with a physician or when picking up prescription drugs. Co-pays are not typically subject to deductibles.

A request from a healthcare provider or patient, presented to a healthcare provider, for payment of services performed.

This is a document attached to an insurance-processed medical claim, in which the insurance provider explains the services they will cover for a patient's healthcare treatments. An EOB might also explain any issues if a claim is denied.

HCPCS is a widely-used coding system used to reference services, devices, and diagnoses administered in the healthcare system. Billing specialist use codes in the HCPCS regularly to file claims. If you want to contact your insurance company to find out if a particular item or service is covered under your policy, they may request the associated HCPCS. CPAPnow is very familiar with the system and we can supply you with any codes you may need.