Insurance and Healthcare Reimbursement

Students procure exhaustive the forthcoming scenario as an diatribe.

As you are completing your audits you perceive-keep Mary Johnson’s chart and attend-to the forthcoming:

Mary Johnson saw Dr. Nichols today for a well-woman exam. Total account are $185.00. Mary has two protection companies:

Primary Insurance

Secondary Insurance


Cigna Health Care

Copay: $25.00

Deductible: $200.00 (already met)

100% utility subjoined copay

80% utility subjoined deductible

Allowed amount: $150.00

Allowed amount: $125.00

Both pretensions were submitted at the identical duration in fault.

Money calm from the resigned: $0.00

  1. Complete the forthcoming investigations providing rationales for your rejoinders:
    1. How plenteous money did Dr. Nichols admit?
    2. How plenteous should BCBS entertain remunerated?
    3. How plenteous should Cigna entertain remunerated?
    4. How plenteous is this pretension overpaid?
    5. Who overremunerated on this pretension?
    6. What would be your proximate steps?
  2. Address how this standing ability be avoided in the future: be inequitable and procure steps.
  3. The well-woman exam showed this resigned due to family fact of cancer would utility from BRCA genetic testing and twain protection companies spoiled this pretension. Format a note of harangue or BRCA testing.

This assignment is exhaustived as an APA diction paper, and should be at lowest 2-3 pages in elongation. Demonstrate your occupation experience and authoritative ethics in your rejoinder.

Assignment Expectations:  

  • Length:
    • answers must fully harangue each investigation in a obvious, summary manner; exhaustive answers procure likely take 2-3 pages
  • Structure:
    • Title and intimation page required
    • harangue each investigation in a numbered list
  • References:
    • References required to be cited if used
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