What is the fixed amount patients pay each time they receive health care services called?

Prepare for your Health Insurance Billing Exam. Utilize flashcards and multiple choice questions, each with explanations. Boost your readiness!

The term you are looking for is copayment. A copayment, often referred to as a copay, is a specific dollar amount that a patient is required to pay out of their own pocket for certain healthcare services at the time of receiving the service. This fixed fee can vary depending on the type of service; for example, a visit to a primary care doctor may have a different copayment than a specialist visit or a prescription medication.

This system is designed to help manage healthcare costs by encouraging patients to share in the expenses of their treatment. By knowing the amount they must pay for certain services upfront, patients can make informed decisions about their healthcare usage.

Coinsurance, on the other hand, is a percentage of the total cost of a service that the patient is responsible for paying after meeting their deductible. A deductible is a specified amount that a patient must pay out of pocket for healthcare services before their insurance begins to cover costs. Using the term ‘insurance’ generally refers to the policy that pays for health services, but it does not specifically define any out-of-pocket payment made by the patient.

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