Medical Billing Terminology: O

O

• OIG Office of Inspector General – Part of Department of Health and Human Services. Establishes compliance requirements to combat healthcare fraud and abuse.
• Out-of-Network (or Non-Participating) A provider that does not have a contract with the insurance carrier. Patients usually responsible for a greater portion of the charges.
• Out-Of-Pocket Maximum The maximum amount the patient has to pay under their insurance policy. Anything above this limit is the insurer’s obligation.
• Outpatient Treatment in a physician’s office, clinic, or day surgery facility lasting less than one day.