What are payments for covered services made to providers by health plans called?

Payments for covered services made to providers by health plans are referred to as "benefits." This term encompasses the amounts that health insurance plans pay to providers for services rendered to policyholders. Benefits are a crucial aspect of health insurance, outlining the coverage that patients can expect, including specifics about what types of services are reimbursable and under what conditions.

Understanding how benefits work is essential for medical coders and billers, as they play a key role in processing claims and ensuring that providers are compensated for their services according to the terms of the health insurance policy. The significance of accurately coding for benefits lies in maximizing reimbursement for services provided while ensuring compliance with the insurance plan's coverage guidelines.

The other options pertain to different aspects of the healthcare billing process. Claims refer to the requests for payment submitted by providers to the insurance plan. Deductibles represent the amount a policyholder must pay out-of-pocket before insurance benefits kick in. Fees are the charges associated with specific services rendered, but they do not capture the concept of payment made by health plans to cover those services. Understanding these distinctions helps clarify how benefits specifically refer to the insurer's contributions toward health service payments.