GLOSSARY OF HEALTH INSURANCE TERMS

R

Reasonable and Customary (R&C) charge — the prevailing charge made by physicians of similar expertise for a similar procedure in a particular geographic area. Also called Usual, Customary and Reasonable Fees.

Referral — the process of sending a patient from one practitioner to another for health care services. Health plans may require that designated primary care providers authorize a referral for coverage of specialty services.

Rehabilitation — Rehabilitative services are normally ordered by a doctor to help a patient recover from an illness or injury. These services are given by nurses and physical, occupational and speech therapists.

Renal (kidney) Dialysis Center — a facility that furnishes the full spectrum of diagnostic, therapeutic and rehabilitative services (except transplantation) required for the care of dialysis patients.

Resident Physician — a physician who has graduated from medical school and is currently in specialty training (interns are now called first-year residents).

Rheumatologist — a physician who specializes in the treatment of rheumatic diseases; inflammation of joints and muscles (e.g. rheumatoid arthritis).

RN — registered nurse, a nurse with two to four years of training.