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

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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?
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This note was uploaded on 01/05/2012 for the course 101 melissa jo taught by Professor Acc101 during the Spring '11 term at Aarhus Universitet.

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

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