Important Terminologies Most Widely Used In Healthcare Domain?
Well in Healthcare space, we utilize Course, Plan, Product, Method codes, Income codes, Conclusion codes, Suppliers, Members/Subscribers, Restorative claims, Healing centre claims, Doctors.
Course - It basically defines the medication details. I.e. the course of medication to be followed
Plan - A plan is the blending of the health protections scope benefits beneath a item and a specific cost-sharing structure, supplier arrange, and service range
Product - A product comprises all plans offered inside the item
Method codes - A rating method decides whether a single normal premium based on the characteristics and claims encounter of a complete participation in an insurance pool
Income codes - Codes represent the category of Insured which lets us know the capacity of Insured to pay premium for the Face Amount selected.
Conclusion codes - Codes denote the Policy level decisions
Suppliers - Suppliers basically represent Third party verifiers, Diagnostic’s, Network providers
Members/Subscribers - He is the person responsible for paying the premiums
Restorative claims - It may be a benefit that permits an insured to restore the whole entirety safety net provider within the arrangement year when it gets depleted due to brought about claims.
Healing centre claims - These are related to Claims pertaining to particular category.
Doctors - As the name represent it is straightforward, they are Family doctor if any or Treating doctorsÂ