Certified Revenue Cycle Representative (CRCR) Practice Exam

What does the term "Subscriber" refer to in the context of healthcare plans?

1. An employer, a union, or an association

2. A healthcare professional with expertise in a specialty

3. A person receiving care from a healthcare provider

4. An individual who contributes to the purchase of healthcare services

The correct answer is: An employer, a union, or an association

In the context of healthcare plans, the term "Subscriber" specifically refers to an individual who is the primary insured person under a health insurance policy. This person typically pays the premiums for the insurance coverage and is linked to the healthcare benefits provided by that plan. Focusing on the selected answer, an employer, a union, or an association can indeed act as the subscriber when they provide a health insurance plan to employees or members. This means they are the ones who allocate funds towards the cost of health coverage for eligible individuals. By contributing to the purchase of healthcare services, they step into the role of the subscriber, facilitating access to health benefits for those covered under the plan. In contrast, while healthcare professionals are crucial for patient care, they do not fit the definition of a subscriber as they are not responsible for purchasing the services or coverage. Similarly, a person receiving care is defined as a patient or member but not a subscriber, as they are not typically involved in the financial aspects of the healthcare plan. The option referring to an individual who contributes to the purchase of healthcare services is too broad and does not encompass the specific definition of a subscriber, which necessitates a formal insurance arrangement.