ReimbursementPregunta 74 de 100
A patient's total 'out-of-pocket maximum' represents:
a.The amount the provider writes off
b.The plan's monthly premium
c.The amount the payer pays the provider
d.The most a patient will have to pay for covered services in a benefit period before the plan pays 100%
Explicación
The out-of-pocket maximum caps the total deductible, copays, and coinsurance a patient pays in a benefit period; once reached, the plan pays 100% of covered services. Premiums generally do not count toward this maximum. Knowing the patient's remaining out-of-pocket helps set accurate expectations for patient responsibility.
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