Chiropractic Business Midterm Practice Exam

What term describes the portion of costs paid by the insurer after meeting the deductible?

Copayments Deductible CPT codes Coinsurance

Correct Answer:

Coinsurance

Explanation:

Coinsurance describes the portion of medical costs that the insurer pays after the deductible has been met, with the remaining charges typically shared by the patient as a percentage. This means once you’ve reached your deductible, you and the insurer split the costs according to a set rate (often 80/20 or 70/30) until you hit the out-of-pocket maximum. Copayments are fixed dollar amounts paid at the time of service and don’t depend on total charges after the deductible. The deductible is the amount you must pay out of pocket before insurance starts contributing. CPT codes are billing codes for procedures and don’t determine how costs are shared.

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