Warm Springs Rehabilitation System

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Glossary of Terms

Co-Insurance and/or Co-Pays: Your insurance designates this amount as a percentage of the total amount paid.

Coordination of Benefits (COB) Rules: Rules that determine which insurance is to be billed first (primary) for services, when a patient is covered by more than one carrier. State and federal.

Deductible: Amount designated by your insurance company as your responsibility, reported as an amount that must be paid before insurance begins to pay.

Explanation of Benefits (EOB): The notice you receive from your insurance company after getting medical services from the hospital. It tells you what was billed, the payment amount approved by your insurance, the amount paid, and the amount you are responsible for as the patient or insured.

Medicare- Part A: Usually referred to as a hospital insurance, it helps pay for inpatient care in hospitals and hospices, as well as some skilled nursing costs.

Medicare- Part B: Helps pay for doctor services, outpatient care, and other medical services not paid for by Medicare Part A.

Medicare Summary Notice (MSN): The notice you receive from Medicare after getting services from the hospital. It tells you what was billed to Medicare, Medicare’s approved payment, the amount Medicare paid, and what you have to pay. Also called an Explanation of Medicare Benefits (EOMB).

Primary Insurance: The insurance company responsible for paying your claim first.

Secondary Insurance: Designation given to the insurer that has second priority for payment of a claim. Applies after the primary insurance pays or rejects an insurance claim. Whether payment is made depends on your insurance benefits, your coverage, and your benefit coordination.