What is the term for a contract between a policyholder and a third-party payer to reimburse for medical treatment costs?

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

The term that describes a contract between a policyholder and a third-party payer, typically an insurance company, which provides reimbursement for medical treatment costs, is health insurance. This type of insurance provides financial coverage for the policyholder against various health-related expenses, ensuring that they receive necessary medical care without incurring overwhelming costs out-of-pocket.

Health insurance is designed to mitigate the financial risk associated with healthcare expenses, making it feasible for individuals to seek medical attention when needed. It typically involves a premium paid by the policyholder to maintain coverage, as well as other financial structures such as deductibles and copayments that may apply when receiving medical services.

The other terms mentioned—coinsurance, prospective payment system, and single-payer plan—refer to more specific concepts related to health insurance. Coinsurance is a cost-sharing arrangement where the insured pays a percentage of the costs after meeting their deductible. A prospective payment system is a method of reimbursement for hospitals based on predetermined rates for specific services, often used in Medicare. A single-payer plan refers to a healthcare system where a single public or quasi-public agency manages health care financing, which is a different concept from the contractual arrangement defined by health insurance.

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