Question

multiple choice question

a specified (fixed) amount that a beneficiary must pay at the time of a healthcare encounter is called a ______.

• premium
• deductible
• coinsurance
• copayment

Explanation:

Analyze the question prompt

The question asks for the term that describes a "specified (fixed) amount that a beneficiary must pay at the time of a healthcare encounter." This is a fundamental concept in healthcare billing and insurance.

Evaluate the options

• premium: The periodic payment made to keep an insurance policy active. It is not paid at the time of a healthcare encounter.
• deductible: The amount an insured person must pay out-of-pocket for medical services before the insurance policy begins to pay.
• coinsurance: A percentage-based share of the costs of a covered healthcare service after meeting the deductible.
• copayment: A fixed, flat fee that a patient pays directly to the healthcare provider at the time of receiving a specific medical service.

Connect to mastered concepts

Using the Cost-Sharing and Copayments knowledge points, we can identify that a fixed, flat fee paid at the time of service is defined specifically as a copayment (or copay). This distinguishes it from percentage-based cost-sharing (coinsurance) or annual thresholds (deductibles).

Answer:

• premium
• deductible
• coinsurance
• copayment (Correct answer)