Title: Describe how medical limits may affect an insurance carrier’s payment on a claim.
Course: Medical Coding and Billing I (14151-III) > Section: Understanding the U.S. Healthcare System

Description should include the following:

- Deductible
- Carryover provision
- Family deductible
- Aggregate deductible
- No aggregate deductible
- HSA
- Coinsurance
- Coinsurance limit
- Out-of-pocket limit
- Preexisting conditions
- Health Insurance Portability and Accountability Act (HIPAA) and preexisting conditions
- ACA

Process/Skill Questions

- How do you process a claim with coinsurance?
- What are preexisting conditions?
- Who does the ACA protect?
- How are copays different than coinsurance or deductibles?