Pre-Insured Members: A Case Study

AI may enroll in a managed care plan (plan) or American Indian Health Program (AIHP)

In a study entitled " Who are the Remaining Uninsured and Why Haven't They Signed Up for Coverage?" there were factors identified that attributes to higher rates of uninsured groups. The factors are as follows: the ACA's exclusion of undocumented immigrants from the coverage expansion; the lack of Medicaid expansion in 19 states; less awareness of marketplaces in some demographic groups; concerns about affordability and eligibility; difficulty selecting plans during the enrollment process, and lack of assistance in selecting

The HIPAA Privacy rule is a federal law that established a national standard that protects patient’s privacy. The Health Insurance Portability and Accountability Act (HIPAA) was established in 1996. This act made it possible for insurance coverage to transfer and continue when people transferred jobs or even lost their job. It established national standard for health care information on billing and other processes that handled patient health information. The privacy rule was not an original part of HIPAA

On February 20th 2003 the HIPAA security rule was published by (HHS) the Department of Health and Human Services. Entities with small health plans were given over three years to comply with the security rule, while the larger entities had two years from the publications original date to comply. The HIPAA security rule is the same as it has been since its implementation more than 10 years ago. On January 25, 2013 the act was amended by the Omnibus Rule to add the Health Information Technology for Economic and Clinical Health (HITECH) Act. The HIPAA Security Rule defines all of the administrative, physical, and technical safeguards that must be incorporated into an organizations HIPAA security compliance plan. There are five categories in which the HIPAA security rules are grouped in. Those five groups include three safeguards categories: administrative; physical and technical safeguards. Along with organizational standards and finally documentation requirements followed by policies and procedures.

Your OHIP Card Could be Your Ticket to Better Health Support in Your Home, or in a Long-term Care Facility

The perspective I have about the recent efforts to help the uninsured in the U.S is it has come a long way towards positive change since the 1950’s till now. The Patient Protection and Affordable Care Act of 2010 (ACA)/ Obama Care, has provided the uninsured with medical insurance and access to reduce the risk of health issue through prevention. The law expands eligibility for public insurance, use of federal subsidies to make private coverage more affordable, new rules on insurers and employers to make coverage more accessible, and require all Americans to have some form of health insurance (Knickman and Kovner, 2015). The outcome of this enactment; 5 million Americans enrolled in state Medicaid programs, 8 million received public subsidies,

The HIPAA (Health Insurance Portability and Accountability Act) Privacy Rule, is a law that was enacted in 1996 by the United States Congress and signed into law by then President Bill Clinton (“Health Information Privacy”). The point of the law is to provide federal protections for an individual’s health information so that it may not be disclosed without the permission of the individual. In short, the law was meant

9. A pre-existing condition refers to the physical or mental condition of the applicant in a period prior to the date of entry into force of the policy. In general, insurance companies recognize it to reduce the opportunity to pay claims. The insurance company does not cover pre-existing conditions in the policy. If the insured wants it to be covered by the policy, then it will charge a higher interest rate (premium).

Normal open enrollment for health insurance coverage ends February first of every year, but allows a late entrance penalty for voluntary health benefits such as dental. The penalty, including a 12-month and 24-month waiting period for certain benefits, is in place to avoid the existence of adverse selection since employees would only enroll in the plan when they needed healthcare goods and services, if not waiting period existed for late

HIPPA stands for” Healthcare Insurance Portability and Accountability Act” The roots of HIPAA stem from the early 1990s, when it first became apparent that the medical care industry would become more efficient by computerizing medical records. There was also

Jeff Collins is senior vice president and area manager for Kaiser Foundation Hospitals/Health Plan in Roseville. He has responsibility for all local health plan and hospital services at the 340-bed Roseville Medical Center and, partnering with physician leaders, is responsible for the health care of more than 280,000 Kaiser Permanente members.

This letter is in regards to request cancelation of the Cobra Insurance and for the Reimbursement in the

Although granted in the form of a tax credit, the subsidy can be used in advance to lower your premiums.

Medicaid and Commercial insurance plans require that newborns be enrolled in insurance within 30-31 days from a date of birth. Currently, the nonmember policy states that for non-member Medicaid newborns there is the option of being treated at KP for the first 60 days of life. I would make a guess that the same policy would apply for uninsured and commercial insured non-members.

I think you should review the patient account b/c on PM shows that the patient is active with BCBS effective 04/01/2016 .The receptionist should be see that and verify insurance coverage at the moment the patient was registered. If the insurance was inactive the receptionist should be expired the Insurance.