What term refers to the amount a patient must pay when their insurance covers 70% of the allowed amount?

Prepare for the NHA Billing and Coding Specialist exam. Study effectively with flashcards and multiple-choice questions offering explanations and hints. Ensure you're ready for success!

The term that accurately describes the scenario where a patient pays a certain percentage of the allowed amount while the insurance covers the remaining percentage is known as coinsurance. In this case, if the insurance covers 70%, the patient is responsible for the remaining 30% as their coinsurance payment.

Coinsurance is a cost-sharing requirement where a patient pays a percentage of the total bill, as opposed to a flat fee. This arrangement typically comes into play after a deductible has been met, meaning that the patient must first pay a certain amount out-of-pocket before the insurance starts making payments.

To provide context, a copayment is a fixed dollar amount paid at the time of receiving medical services, while a deductible is the total amount a patient must pay out-of-pocket before insurance coverage begins. A premium, on the other hand, is the regular payment made to keep the insurance policy active regardless of services rendered. Thus, in terms of a percentage responsibility after the insurance has paid its part, coinsurance is the correct term.

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