North Carolina Accident and Health Practice Exam 2025 – Complete Prep Resource

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What is the term "provider" in health insurance?

A healthcare professional or institution offering medical services

The term "provider" in health insurance refers to healthcare professionals or institutions that offer medical services to patients. This can include a wide range of entities, such as doctors, hospitals, clinics, and other healthcare facilities that deliver patient care. Providers are essential in the healthcare system as they are directly responsible for diagnosing, treating, and managing patients' health conditions.

Recognizing the definition of a provider is important for understanding how healthcare delivery operates within the insurance framework. It distinguishes providers from insurers, who are responsible for underwriting policies and managing risk, as well as from agents who sell these insurance policies and individuals who are insured. Understanding this terminology clarifies the roles that each party plays in the healthcare and insurance landscape.

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The insurance company that underwrites the policy

The representative who sells insurance policies

The individual covered under an insurance policy

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