Case Study : Lesson 9 Exercise 1

IgG – funtions in neutralizing, opsonation, compliment activation, antibody dependent cell-mediated cytocity, neonatal immunity, and feedback inhibition of B-cells and found in the blood.

I do not understand how can someone see people be treated the way patients at Willow brook were treated and no do anything about it. Patients at Willow brook were suffering. Seen their families talk about what they went thru made me very sad. I do not blame the parents for taking their sons/daughter to this facility. They did what they thought was right. They probably never imagined that this was going to happen. They took their children there thinking they were going to get help and get the right treatment. Thankfully some of them were taken from their families just in time, before something worst happen. The students and their parents, they were all victims of the inhumane way they were treated at Willow brook.

In an attempt to keep your medical cost for services to a minimum, we have adopted the following policy regarding payments and billing. If you do not have insurance coverage, payment will be due in full amount on the day the service is giving.

To start the physician insurance claim cycle, the offices staff need to have the first encounter with the new patient. In this first encounter the office staff collect general patient information to ensure the new patient eligibility and benefits status. The Information that collect is full name, date of birth, address, insurance policy and reason of the visit. The second step the office start will verify the full benefits of the patient before the first doctor visit to make sure the patient eligibility and to stablish the patient responsibility at the time of the office visit. The day of the visit the patient complete the new patients forms and the office staff ask and make photo copy the patient insurances card and id card for purpose of

The applicants are morally correct as long as their action promotes their long term interest. If their action produces or will produce for them a greater outcome of good, versus evil in the long hall than any other alternative, than that action is the right one to act on, and the individual should take that to be a moral act. An Assessment of Morality by Ethicsinbusiness.net

“Mayo Clinic has established arrangements with several different types of health care insurers” (n.d., Mayo Clinic). It is important to review information and resources relevant to your health care coverage prior to setting up your appointment. Mayo clinic also has resources available to assist patients with the insurance process including pre-authorizations and pre-certifications from their insurance company. Mayo clinic accepts coverage from several contracted insurance plans. Mayo clinic may not offer the highest benefit level or participate in every product offering from the every health plan listed; benefit coverage is determined solely by the insurance provider. A few of health care providers contracted with Mayo Clinic

She beliefs that external factors – her boyfriend was under pressure for a while because he was laid off – were also responsible for her his boyfriend’s actions. She may blame these external circumstances for leading to her abuse.

Criminal Justice professionals have certain responsibilities and duties in order to fulfill the needs of

Offices should have a well written payment/collection policy to prevent confusion in the office. All patients should never be confused about if and how much they need to pay. There are a variety of policy rules that can be overwhelming. Copayments can be tricky because sometimes you must pay them right away and sometimes they are billed to you later. If a patient does owe a payment and is not sure what for; the staff should be familiar with the policies to help explain the payment if needed.

Patient Check-in- This is when personal details are provided by the patient to the requested provider. The patient will agree and sign patient release information forms, complete a full medical history documents, and approve obtaining copies of legal identification and insurance information. This information provided should be detailed as much as possible to avoid any document errors in the future relating to accurate treatment and billing.

Patients are responsible for paying a co-payment when visiting a doctor. After the patient is seen, the provider submits claim forms to the insurer for the services rendered. Once the claims are processed the insurer will reimburse the provider (Austin & Wetle, 2012). If a patient goes out-of-network, they are required to pay the provider in full. Afterwards the patient can submit a claim for reimbursement.

Patient demographics (full name, date of birth, emergency contact information, next of kin, employer information etc...)

-4/SD = -4/2.7 = -1.48 ≈ -1.5 SD (negative means towards the right therefore there would be an increase)

The administrative life cycle of a physician-based claim has several important steps that need to be followed accordingly. The first step in the life cycle starts with Patient Scheduling and Registration. The second step is Insurance Verification. Insurance verification is a very important step because when the patient comes in for his/her visit they will need to know and be prepared to either pay something or not. The third step, once the patient comes in for their visit, is Patient Co-Pay Collection. Next is Patient Exam-Documentation. Then, Order Management. After the patient visit, the next step is Coding and Charge Entry. The rest of the steps are as follows in order: Claim Checking and Error Resolution, Claim Submission, Payment Processing

CMS has differential payment for inpatient and observation status patient services (Engoren. et., 2016). Observation status is covered under Medicare Part B, which is an optional coverage for beneficiaries and they are usually responsible for the co-payments, which is 20 percent of the Medicare payment for out payment services for such items as labs, x-rays and any medications they usually take at home. The beneficiary will also have to pay their yearly deductible for their Part B. The patient will receive a bill for non-covered services, including any required co-pay or deductibles. While patients are in observation, they could be charged co-payments for individual services they receive. Patients who do not have part B Medicare may incur