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Base Capitation

Total amount covering cost of health care per person, minus mental health or substance abuse services, pharmacy, and administrative charges.

Basic Hospital Expense Insurance

Benefits provided by hospital coverage for room and board and miscellaneous hospital expenses for specified number of days during hospital confinement.

Bed Days/1,000

Number of inpatient hospital days per 1,000 members of the plan.

Benefit Levels

Maximum amount a person is entitled to receive for particular services as described in the contract with insurer or health plan.

Benefit Package

Description of services offered by insurer or health plan to those covered under the terms of health insurance contract.

Benefit Period

Period during which Medicare beneficiary is eligible for Part A benefits. Benefit period is 90 days, beginning the day of patient's admission to hospital and ending when individual has not been hospitalized for a period of 60 consecutive days.

Billed Claims

Amounts submitted by health care provider for services provided to a covered individual.

Birthday Rule

A method determining which parent's medical coverage is primary for dependent children: parent whose birthday falls earliest in the year is considered to have primary plan.

Blanket Insurance

Health Insurance contract covering all of a class of persons not individually identified in the contract.

Blanket Medical Expense

Policy or provision in Health Insurance contract that pays all medical costs, including hospitalization, drugs, and treatments, without limitation on any item except for possibly a maximum aggregate benefit under the policy. Frequently written with an initial deductible amount.

Blue Cross

Nonprofit hospital expense prepayment plans primarily designed to provide benefits for hospitalization coverage, with certain restrictions on the accommodations to be used.

Blue Plan

Generic designation for those companies, which usually write a service rather than a reimbursement contract, authorized to use the designation Blue Cross or Blue Shield and the corresponding insignia.

Blue Shield

Blue Shield plans are prepayment plans offered by voluntary nonprofit organizations that cover medical and surgical expenses.

Board Certified

Physician or other professional who has passed an examination certifying him as a specialist in a particular medical area.

Board Eligible

Professional person or physician eligible to take a specialty examination.

Business Overhead Expense

Disability income policy indemnifying the business for specified overhead expenses incurred should the business owner become totally disabled.

 

 
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