Question

Medical Insurance class:

Why is important to receive a monthly enrollment list from a health plan?

What are write-offs and how do they affect the practice accounting system?

How are group health plans an TPAs governed by HIPAA?

Answer 1

Health plan is also called as health insurance plan that protect your family from unexpected medical expenses with health insurance.Depending on the choosen health plan or insurance plan that provides coverage for medical expenses to the policy holder such as for critical illness expenses,surgical expenses,hospital expenses etc.

a.Health insurance is a contract between the individual and an health insurance company.When an individual buy a premium/policyor a health plan he has to pay a monthly fee and in return,the company agrees to pay part of your medical expenses when you get sick or hurt.Having health insurance helps you to protect you from unexpected costs like these.One's health policy will outline what types of care,treatments and services are covered,including how much the insurance company will pay for different treatments in different situations.Documentation of eligible members of a capitated plan registered with a particular PCP for a monthly period.

b.Write-offs/write down bad debt is a process of cancellation from an account of a bad debt or worthless asset.Write-off is an accounting action whereby firms declare an asset book value as zero,where the loss enters the accounting system as an expense.

In the accounting system or in income tax statements,this is a reduction of taxable income.The write off or bad debt refers to outstanding debt that a company cosiders to be non-collectable after making a reasonable amount of attempts to collect.These debts are worthless to the company and are written offs as an expense Here they divide the bad debt by the total accounts receivable for a period and multiplyby 100.Theus the companies or accounting system will creates this as an uncollectable and attempts to account for this right away.

c.Under HIPPA a plan called a self-insured plan of an employer or employee organization to provide health care to the employees,former employees,and their families.Plans that are self-administered and have fewer than fifty participants are not group health plans.

If the plan has 50 or more participants or if a third party administers it,its consider as a group health plan according to the HIPAA regulations.If the plan meets this definition,its considered a "covered entity" subject to HIPAA administrative regulations.This regulations have includes regarding the standard transactions and codes sets,privacy and security when the final security rules are published.

Here in a group health plan provides all of its benefits through insurance contracts with health insurance companies or HMO's.Here the plan provides any benefits on some other basis,rather than through insurance contracts its subject to all of HIPAA,just as if it were an insurance company.