Which provision ensures that an insured patient's benefits from 3rd-party payers do not exceed 100% of allowed medical expenses?

The provision that ensures that an insured patient's benefits from third-party payers do not exceed 100% of allowed medical expenses is the coordination of benefits. This mechanism is essential when a patient has multiple insurance policies; it helps to organize the payments so that the total reimbursement does not surpass the total allowable medical expenses incurred by the patient.

When coordination of benefits is applied, each insurance company determines its payment responsibility and the order of payment between the plans, ensuring that if one policy pays a certain amount, the other policy will only pay up to the balance of the expenses, allowing for a maximum combined benefit of 100% of the allowed costs. This system prevents overpayment to the insured and maintains equity among insurers.

The other options do not serve the purpose of balancing the payouts from multiple insurance policies to stay within allowable medical expenses. Benefit limitation refers more to caps on certain types of services or time periods. Policy exclusions detail specific circumstances or conditions under which benefits will not be paid. The deductible clause pertains to the out-of-pocket amount the insured must pay before the insurance begins to pay benefits, which does not specifically manage benefit amounts when multiple policies are involved.