Case Study 2-1 - Case Study 2 Question One Copayments and...

Info icon This preview shows pages 1–2. Sign up to view the full content.

View Full Document Right Arrow Icon
Case Study 2 Question One: Copayments and Contractual Discounts Blue Cross Blue Shield Copayment sent a bill for outpatient surgery that listed: charges as $950, a provider payment of $760 (80%), and a copayment requirement of $190 (20%). The surgery center’s statement listed Blue Cross Blue Shield payment as only $374 because of a contractual allowance. Thus, of the $374 + $190 = $564 received by the surgery center, the copayment was actually 34%. When the patient questioned Blue Cross Blue Shield, it responded by stating the following: The patient indeed owed $190, and the details of the surgery center contract were proprietary (confidential). The policyholder could attempt to negotiate a similar discount with the provider. Section A: What do you think? Page 1: Write 220-230 words discussing and explaining your position. Section B: Is there an ethical issue here? If so, what should be done to resolve it? Page 2: Write 300-400 words to answer each question. Use at least 2 peer reviewed articles.
Image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 2
This is the end of the preview. Sign up to access the rest of the document.

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern