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3. A patient who has not paid a bill has come to the emergency room for medical treatment. While there, a medical assistant notices a large amount of money in her purse. The medical assistant tells the security guard. The guard stands at the patient’s room and refuses to let her leave until she pays some money toward her bill. Can the patient file charges against the hospital? If so, what will the proper complaint read?

J. Explanation of Benefits XYZ Insurance Company Explanation of Benefits Walden-Martin Family Medical Clinic 1234 Anystreet Anytown, AK 12345-1234 Patient Treatment CPT Name Dates Code Yan, Tai 01/06/20XX (99205 01/06/20XX 01/06/20XX Totals Gomez, 01/07/20XX Pedro Totals 82947 86580 99212 * Amount Charge Reason Covered Deductible Co-Pay Code Amount Amount Amount Paid At 132.28 03 15.00 11.34 158.62 28.55 28.55 70.92 01/04/20XX 71020 Totals Green, 01/04/20XX 99203 Jana 40.97 111.89 Reason Code: 03 Allowed amount per insurance contract 03 03 125.00 15.00 11.34 151.34 28.55 28.55 69.23 34.95 104.18 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Copyright © 2020, Elsevier Inc. All Rights Reserved. 80% 80% 80% 0.00 80% 0.00 80% 0.00 80% 01/20/20XX Payment Amount 100.00 12.00 9.07 121.07 22.84 22.84 55.38 27.96 83.34 Check No: 56390 $227.25 Using the explanation above answer the following questions: 1. For Tai Yan's office visit, 99205, there is a difference between the Charge Amount and…

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QUESTION 1 Parktown Medical Center, Inc., is a small health care provider owned by a publicly heldcorporation. It employs 7 salaried physicians, 10 nurses, 3 support staff, and 3 clericalworkers. The clerical workers perform such tasks as reception, correspondence, cash receipts, billing, and appointment scheduling. All are adequately bonded. Most patients pay for services rendered by cash or check on the day of their visit. Sometimes, however, the physician who is to perform the respective services approves credit based on an interview. When credit is approved, the physician files a memo with one of the clerks to set up the receivable using data the physician generates. The servicing physician prepares a charge slip that is given to one of the clerksfor pricing and preparation of the patient’s bill. At the end of the day, one of the clerks uses the bills to prepare a revenue summary and, in cases of credit sales, to update the accounts receivable subsidiary ledger. The front office…

7. 41 Develop a context diagram and level-0 diagram for the hospital pharmacy system described in the following narrative. If you discover that the narrative is incomplete, make up reasonable explanations to complete the story. Supply these extra explanations along with the diagrams. The pharmacy at Mercy Hospital fills medical prescriptions for all hospital patients and distributes these medications to the nurse stations responsible for the patients’ care. Prescriptions are written by doctors and sent to the pharmacy. A pharmacy technician reviews each prescription and sends it to the appropriate pharmacy station. Prescriptions for drugs that must be formulated (made on-site) are sent to the lab station, prescriptions for off-the-shelf drugs are sent to the shelving station, and prescriptions for narcotics are sent to the secure station. At each station, a pharmacist reviews the order, checks the patient’s file to determine the appropriateness of the prescription, and fills the order…

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Ann Reynolds has recently been hired as practice manager for Dr. LaRue. In reviewing the financial records of the practice, she notices that a substantial amount of money is owed by patients with outstanding balances. Further review finds that the practice has no written financial policies outlining the responsibility of patients in paying for their costs of medical care. Outline a set of basic financial policies to address patient responsibility for payment of charges.

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An archilect who has recently opened an office is concerned about not being able to pay employees' salaries or he office rent it the architect becomes disabled. Which of the following types of policies should this individual purchase? A. Disability Income B. Business Overhead Expense C. Major Medical D. Comprehensive Major Medical

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Shadyside Insurance Company manages a medical insurance program for its clients. Employees of client firms submit claims for reimbursement of medical expenses. Shadyside processes these claims, checks them to ensure that they are covered by the claimant’s policy, notes whether the claimant has reached any limit on coverage, computes any deductible, and issues a check for the claimant’s refund. Three types of clerks work in the claims processing department: supervisors, senior clerks, and junior clerks. The supervisors are paid $42,000 per year, the senior clerks are paid $37,000 per year, and the junior clerks are paid $32,000 per year. For every 150,000 claims processed per year, Shadyside plans to use one supervisor, six junior clerks, and two senior clerks. Last year, the company processed 2 million medical claims and employed 14 supervisors, 30 senior clerks, and 83 junior clerks. Required Compute the excess costs or cost savings relating to the claims processing staff. How would…

MATCH WITH THE  BEST ANSWER Liability Insurance Mistakes happen. You, your employees, your equipment or your suppliers could make mistakes that ultimately end up hurting your customers, your employees or other people who are involved with your business. To protect your business from being sued, you should consider these types of insurance to limit your liability: 1.   ____General liability   A.  Provides protection if you are sued by a client for errors, omissions or negligence, when performing professional services. 2.   ____Product liability   B.  Covers injury to clients or staff on your premises. 3.   ____ Professional liability insurance C.  Provides protection in the event that your products are defective or cause serious harm to those using them.

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The risk of patients not paying their account balances resulting in bad debt expense is a reality today.  This risk is greater as employers increase out-of-pocket maximums, deductibles, and co-pays as part of their medical insurance plans.  Research and discuss some best practices healthcare organizations are using today to improve their patient liability or balance due collection process.

8. Stan is applying for health insurance. He is worried because he has been experiencing chest pains and shortness of breath lately. He does not mention these symptoms on his application. Which of the following types of fraud is Stan committing? A.hard insurance fraud B. Soft insurance fraud C.discreet insurance fraud D.passive insurance fraud

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