Who is considered the policyholder in health insurance?

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

The policyholder in health insurance is the individual who owns the health insurance policy. This person is responsible for paying the premiums and holds the rights to make changes to the policy, such as adding dependents or making coverage modifications. The policyholder is typically the one who applies for the insurance, receives documentation regarding the terms of coverage, and has the authority to file claims or appeal decisions regarding their health benefits.

The other options don't accurately describe the policyholder's role. A third-party payer refers to an entity, often an insurance company, that pays medical claims on behalf of the policyholder but does not have ownership of the policy. A patient representative typically acts on behalf of the policyholder, but they do not own the policy themselves. A health care provider offers medical services and may be involved in billing, but they are not the owner of the insurance policy. Therefore, the correct understanding of who the policyholder is focuses on the individual with ownership of the policy, which aligns with option C.

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