Glossary of terms for claims

amount covered by your plan
How much Kaiser Permanente paid the provider for the medical service provided, based on contracts or agreements with the provider. If your provider charges more than the amount covered by your plan, you may have to pay the difference.

charges
On your bill, these are the charges for the services you got. You won’t actually pay these amounts. They are the total charges before your health plan pays. Your costs will be lower.

check number
The unique check number for a claim.

claim
A request for payment that you or your health care provider submits to Kaiser Permanente for services you believe are covered.

claim number
The unique number identifying a claim.

claim received on
The date that Kaiser Permanente received the claim from the health care provider.

co-ins (coinsurance)
A percentage of the charges that you pay for covered services. For example, a 20 percent coinsurance for a $100 service means you pay $20.

copay (copayment)
A set amount you pay for a covered service, such as a $10 copayment for an office visit.

date paid
The date Kaiser Permanente paid the health care provider.

date received
The date Kaiser Permanente received the claim.

date(s) of service/service date
The date when the services were provided.

deductible
The amount you pay for covered services each year before Kaiser Permanente starts paying. Depending on your plan you may pay copays or coinsurance for some services without having to reach your deductible. The deductible may not apply to all services.

location
The location of the service provider.

not covered
How much of the cost was not paid by Kaiser Permanente.

processing status
The overall status of the claim.

provider
The name of the service provider.

remarks
Codes describing how the claim was processed.

service description
The description of the medical, surgical, and diagnostic services provided.

your costs
The total of the amounts still owed to the provider, which may include your deductible, any coinsurance and copayment amounts, and the cost of uncovered services.

your plan paid
The amount that Kaiser Permanente paid for the service provided.