- Homework Solutions
- Homework Questions & Answers
If Mr. Gonzales’s insurance is primary, explain how the payment
will be calculated by the insurance carrier for today’s office
visit and two lab
A primary insurance is a policy which pays first as it were the only source of payment. Other insurance of policy holder is used only after the primary insurance reached its financial limit. The co- payment is used to pay the remaining amount.
After the deductible is met for the year, an 80/20 fee-for-service plan will pay 80% of the allowed charge for each procedure.
If Mr. Gonzales’s insurance is primary, explain how the payment will be calculated by the insurance...
You recently received a notification from a primary care physician about some alarming test results for Mr. Walker. His tests indicate that he is pre-diabetic and his BMI is 32. The physician requests a home visit to determine more information on Mr. Walker’s lifestyle. What information would you gather when you visited Mr. Walker? What would be the next steps in assisting Mr. Walker?
what is bundle insurance explain bundle payment
Consider a relatively simple health insurance plan with the following provisions. ofice visits require a co-payment of $40. Emergency room visits have a $325 co-payment. Surgica Expenses operations have a $1,400 deductible (the first $1,400 Is paid out of pocket). The monthly premium is $400. During a one-year perlod, somebody insured by this health Insurance has Fb. 18: Office visit the expenses shown to the right. Complete parts (a) and (b) below. Mar. 26.Emergency room Apr. 23: Otrice visit May...
22. How many business day it take for the insurance company to process an electronic insurance claim and how many days should you allow? 23. If no further response is insurance company about the claim after a month, what should the medical biller do? 24. To confirm that the claim was received, what should the medical biller provide to the insurance carrier? 25. Describe the information provided in the explanation of benefits (EOB). 26. When reviewing an EOB , what...
Explain the relationship between tests of acquisition and payment cycle and tests of accounts payable. Give examples of how these two types of tests affect each other. It will be also valuable if you have any personal experience related to this topic.
How does the primary function of an insurance company compare with that of a depository Institution?
Joseph Appleton's primary care physician has referred him to Dr. Nester, an oncologist C (physician who specializes in diagnosis and treatment of cancer). Preliminary tests show C that Mr. Appleton may have colon cancer. Mr. Appleton, age 77, is uncomfortable about visiting a specialist he has never met. He is especially distraught about the possibility of having a life-threatening illness and does not understand why the physician he has seen for many years cannot take care of the problem. Carmen...
Scenario 1: Mr. Tiny was seen by Dr. Kirt, Aetna was billed out for the services; we accept assignment. Mr. Tiny has a coinsurance of 90/10; assume there is no deductible at this point or copayment. Aetna responded as follows: Office Visit Charges: 190.00 Allowed: 135.00 X-ray Charges: 35.00 Allowed: 18.75 Inj. Morphine Charges: 50.00 Allowed: 25.00 How much would you expect Aetna to pay for his services? $_____.___ (use this format please) Note: You will need to round down as...
Mr. K, a 57-year-old man, presents w/CC of bilateral claudication provoked by moderate exercise. Pt also states extended sitting w/o support of lower extremities results in bilateral lower extremity erythema and occasional pedal paresthesia. Contributing Social hx: Smoker: 30 pack years; little to no regular exercise. Physical examination reveals an overweight male appearing his stated age. Hyperthermia and anterolateral alopecia noted bilaterally in the lower extremities. Blood Tests: Hypercholesteremia Hypertriglyceridemia Differential Diagnosis: Peripheral atherosclerosis, CHF, and peripheral vascular disease. Explain...
1. How does the primary function of an insurance company compare with that of a depository institution? 2. What are the differences between venture capital, Angel venture captial firm, and private equity firms? Give examples what they might invest in and why.