Reimbursement 101: Key terms 

Define and describe the following:

Charge fee: This is the amount a healthcare provider bills for a specific service or procedure before any discount, negotiations, or adjustments are made. It is essentially the provider of services rendered to patients. 

Rate: Is the context of healthcare typically refers to the amount set for a specific service or procedure that a provider will receive for providing care. This term can encompass various types of rates. 

Fee scheduled: Comprehensive listing of the amount that healthcare providers can charge. 

Claim: Formal request for payment that a healthcare provider submits to an insurance company or government program for services rendered to a patient. This request outlines the medical services provided and seeks reimbursement based on the patient's insurance coverage. 

Third-party payers: Entities that provide reimbursement for healthcare services on behalf of the patient. These can include insurance companies, government programs, or other organizations that pay for medical expenses incurred by the patient.