Illinois health insurance policies are riddled with incomprehensible terms. Health plan jargon boggles most consumers, making it even more challenging to find adequate Illinois health insurance coverage. Illinois Life and Health compiled the most commonly used acronyms and their definitions to simply the process obtaining Illinois health insurance quotes:
ASO (Administrative Services Only) – A covenant by which the employer outsources the administrative tasks claims processing and billing to third party to manage the employer bears the risk for claims. Many Illinois health insurance, which are self insured, opt for this type of arrangement to reduce costs.
COB Coordination of Benefits Individuals who carry Medicare and another Illinois heatlth insurance plans are an example of coordination of benefits. Coordination of benefits is when two different health plans share health care costs, requiring a coordination of health benefits
DME Durable Medical Equipment goods prescribed for follow up medical care. Such as crutches, portable toilet, catheters.
HIPAA Health Insurance Portability and Accountability Act – The federally lauded act and state law requiring medical facilities to maintain patient privacy, sharing medical information to coordinate coverage with Illinois health insurance companies and providers.
TPA – Third party administrator (TPA) – An appointed agency or representative (not a policyholder or Illinois health insurance provider) hired by an employer to manage health care claims pay providers processing.
PCP Primary Care Physician An insure individual’s general practitioner, who makes other specialist referrals.
OTC Over the counter Most Illinois health insurance plans do not cover over the counter medication.