HCR 220 week 3 checkpoint

HCR 220 week 3 checkpoint - their insurance. If they chose...

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There are a number of factors that determine a patient’s benefits eligibility. One factor of eligibility is to check and see if premiums are required; if they are required then patient must have paid them on time. For Medicaid; eligibility can change monthly and for employer-sponsored health plans employment status can be the deciding factor. If the plan is an HMO then the provider must be a plan participant, the patient is listed on the plan’s enrollment master list, and the patient is assigned to the PCP as of the date of service. Other factors affecting patients benefits eligibility is checking the amount of copayment and whether the planned encounter is for a covered service. If an insured patient’s policy does not cover a patient service, then the situation is discussed with the patient. Patients should be informed that the payer does not pay for the service and that they will be responsible for the charges. The patient should be informed that their prenatal care and delivery is not covered by
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Unformatted text preview: their insurance. If they chose to continue with care in the facility they must be willing to cover these charges. Service to be performed: __Prenatal Care Estimated charge: __$1000.00__________ Date of planned service: _____October 24, 2010 _____ Reason for exclusion: _Prenatal care is not covered under insurance _ I, __Fernandez-Valle Nancy , a patient of _Dr. Ross _, understand the service described above is excluded from my health insurance. I am responsible for payment in full for this service. Service to be performed: __Delivery __ Estimated charge: ____$1,300.00 Date of planned service: November 18, 2010 ______ Reason for exclusion: _Delivery is not covered under insurance. I, _Fernandez-Valle Nancy _, a patient of _Dr. Ross, understand the service that is described above is excluded from my health insurance. I am responsible for payment in full....
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This note was uploaded on 04/19/2011 for the course HCR 220 taught by Professor Cvibanez during the Fall '10 term at University of Phoenix.

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HCR 220 week 3 checkpoint - their insurance. If they chose...

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