Co-insurance refers to:

Co-insurance refers to:

• A. The total amount billed to a patient
• B. A fixed amount that the policyholder must pay
• C. The percentage of the bill the policyholder must pay
• D. The full coverage of healthcare costs

Answer: (C)

Co-insurance is defined as the percentage of a healthcare bill that the policyholder is responsible for paying after they have met their deductible. It typically follows a certain arrangement where the insurance company covers a significant portion of the costs, while the policyholder pays a pre-determined percentage. For example, if a policyholder has an 80/20 co-insurance agreement, this means that the insurance company pays 80% of the covered expenses, and the policyholder is responsible for the remaining 20%. Understanding this concept is crucial in medical billing and coding as it directly impacts how patients are billed and how much they need to budget for medical expenses. Recognizing co-insurance helps in determining the out-of-pocket costs individuals might face and plays a vital role in the overall management of healthcare finances. The other options do not accurately capture the nature of co-insurance. The total amount billed to a patient does not factor in the specific percentage structure that defines co-insurance. A fixed amount that the policyholder must pay describes a co-payment, which is distinct from co-insurance. Finally, full coverage of healthcare costs contradicts the definition of co-insurance, as it suggests no out-of-pocket expenses for the policyholder, which is not the

Co-insurance is defined as the percentage of a healthcare bill that the policyholder is responsible for paying after they have met their deductible. It typically follows a certain arrangement where the insurance company covers a significant portion of the costs, while the policyholder pays a pre-determined percentage. For example, if a policyholder has an 80/20 co-insurance agreement, this means that the insurance company pays 80% of the covered expenses, and the policyholder is responsible for the remaining 20%.

Understanding this concept is crucial in medical billing and coding as it directly impacts how patients are billed and how much they need to budget for medical expenses. Recognizing co-insurance helps in determining the out-of-pocket costs individuals might face and plays a vital role in the overall management of healthcare finances.

The other options do not accurately capture the nature of co-insurance. The total amount billed to a patient does not factor in the specific percentage structure that defines co-insurance. A fixed amount that the policyholder must pay describes a co-payment, which is distinct from co-insurance. Finally, full coverage of healthcare costs contradicts the definition of co-insurance, as it suggests no out-of-pocket expenses for the policyholder, which is not the