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
tests.
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?
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...
what is bundle insurance explain bundle payment
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...
1. The patient is insured by a PPO with 100 percent coverage after a copay of $15. The patient was seen in the office for a checkup, and the total charges were $115. What amount must the patient pay? When? What amount must the insurance plan pay? When?2 Afaf Darcy is insured by an HMO with a $10 copay and out-of-network coinsurance on charge balances of 90-10. She needed ysical therapy after her knee replacement. Her HMO pays for eighteen...
You will be responsible for completing the payment posting process for a patient in your office. Bill Barnes was seen in your medical office on 4/13/2015 for a sick visit. While at the office, a chest x-ray and a urinalysis was completed. He pays $ 25.00 cash for his co-pay, and you submit his claim to the insurance company for payment. You received the EOB and insurance payments from his claim submission. You are responsible for posting all payments to...
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...
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.
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?