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TABLE OF CONTENTS

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)
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)





Healthcare Bill was signed
Into law and was
effective  09-24-10

Read the entire HR
Healthcare Reform Bill
by clicking on the pdf icon.

UPDATES:  New Healthcare Bill updates:
As of 03/23/2010

Pre-existing conditions
Children on Policy
Lifetime Limits