TABLE OF CONTENTS

Employee Assistance Program (EAP)

Evidence of Coverage (EOC)

Employee Retirement Security Act (ERISA)

Explanations of Benefits (EOB)

Explanations of Payments (EOP)

Federal Acts

HIPAA (Federal Privacy Act)

Health Maintenance Organization (HMO)

Indemnity Medical Plans

Letter of Creditable Coverage (LCC)

Medical Billing Advocacy

Medical Claim Types

Medical Insurance Plan Year

Medical Insurance Riders

Member Payment Responsibilities

National Medical Provider Networks

Outline of Coverage (OOC)

Patient Bill of Rights

Policy Benefit Maximums

Policy Exclusions

Preferred Provider Organizations (PPO)

Referrals and Primary Care Physicians (PCP)

Annual or Wellness Exam Benefits

Appeals and Grievance Rights

Authorizations and Pre-Certifications

Billing Services

Coordination of Benefits (COB)

Deductibles (DED)

Durable Medical Equipment (DME)

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UPDATES:  New Healthcare Bill updates:

As of 03/23/2010

Pre-existing conditions

Children on Policy

Lifetime Limits