hsm210_appendix_f - reimbursement amount however does not...

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Appendix F HSM/210 Version 3 1 Associate Level Material Appendix F Scenario for Week Seven Discussion Question 2 You are a case manager working for a patient care advocacy group. Most of the work you do is with the local dialysis center. In your position, you enroll and work with clients to help them obtain the services and benefits that will pay for hemodialysis.* Additionally, you arrange for transportation to and from the center and assess the clients’ other social needs. Because dialysis centers are costly to build and run, many communities do not have dialysis centers. Hemodialysis is performed two or three times a week and can be costly to clients because of transportation costs. Some patients have no alternative but to travel a long distance for treatment. Medicare, Medicaid, and other third-party payers reimburse dialysis centers for treating patients. The
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Unformatted text preview: reimbursement amount, however, does not always cover the center’s costs, and some people do not receive any insurance coverage. To remain profitable, this dialysis center has decided to accept only patients whose insurance coverage pays at least 90% of its costs. The dialysis center is located in a rural county 200 miles from a city. You are now put in the position of informing current and future clients that they cannot receive dialysis at this center unless they can cover 90% of the costs, either out of pocket or with insurance, as well as helping those patients without sufficient coverage find alternate funding sources for their treatment. *Hemodialysis is a procedure that eliminates waste products from the blood when the kidneys have failed. It is a means of maintaining life while awaiting a kidney transplant....
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