Who should be responsible for paying for a medical procedure that is not approved by an insurer?
Ans) If an insurance company denies a service stating it was not medically necessary and the physician believes it was then appeal the decision with a statement from the physician.
- If an insurance company admits that a patient signed an
assignment of benefits document and that it inadvertently paid the
patient instead of the physician, the insurance company
should
pay the physician within 2-3 weeks and honor the assignment even
before the company recovers its money from the patient.
Who should be responsible for paying for a medical procedure that is not approved by an...
A health insurer has determined that the reasonable and customary fee for a certain medical procedure is $1220. They suspect that the average fee charged by one particular clinic for this procedure is higher than $1220. The insurer wants to perform a hypothesis test to determine whether their suspicions is correct. Preliminary data analysis indicate that it is reasonable to apply a z-test. Assume that :sd =$238, n=22, and the significance level is 0.10. Express the decision criterion for the...
Our Town Medical Center has hired a new Chief Information Officer who is responsible for the information security plan. She has decided that HIPAA is outdated, complying with HIPAA security standards is too costly, and that the medical center would be better to save the money spent and use to deal with a data breach. She has stated that her philosophy is that, “Nothing is going to stop breaches, so why waste our money?” This is concerning to you in...
Medical Procedure Which process step should be standardized? Which process steps should be more artistic? Explain
Why should the person who keeps the records of an asset not be the person responsible for its custody, provide an example?
1. Should some services remain as an inpatient procedure/process in the medical field, or should healthcare push the envelope to transition more inpatient services to outpatient? 2. While patients aren’t able to rest because of constant monitoring, should the patients still be discharged to home care if they do not have mirrored care? What are the dangers/ impact? Anyone with statistics on returning patients due to complications arising at home?
6. Consider how medical insurance affects the quality of medical services. Suppose the typical medical procedure costs $ 100, but the person with health insurance pays only $ 20 out of pocket. Your insurance pays the remaining $ 80. (The health insurance company recovers the $ 80 for the premiums, but the premiums paid by a person do not depend on the procedures that are done.) a. Draw a market demand curve for medical procedures. (In your diagram, the horizontal...
The issue of who should be responsible for dealing with work stress—the individual or the organization—is an important one. What do you think? What are your arguments for and against each position? What is the role of the individual and what is the role of organizations, and managers in dealing with stress?
Does it matter whether buyers or sellers are legally responsible for paying a tax? A. Yes, the tax is more efficient if consumers pay the tax. B. No, the market price to consumers and net proceeds to sellers are the same independent of who pays the tax. C. Yes, the tax is more equitable if sellers pay the tax.
The board of directors is responsible for all of the following EXCEPT: 1) declaring and paying a corporate dividend to shareholders. 2) electing new directors to replace directors who resign. 3) appointing and removing corporate officers. 4) determining employee compensation, especially bonus and incentive plans. authorizing major new decisions such as a new plant or factory or entry into 5) a new foreign market.
Describe the purpose of a project charter. Should the project manager be responsible for preparing it? If not, who should? If so, is there any disadvantage to holding the PM responsible for its preparation? Regardless of who prepares it, who should sign the charter?