Critical Thinking Questions – Health Insurance Today
Please answer questions A, B, and C under “Critical thinking” in Chapter 8 of the Health Insurance Today Workbook. Enter your answers into a Word document named “FederalPlansWorkbook”.
A.Explain the difference between “categorically needy” and medically needy” and give example of individuals who fall into each group.
B.You are a health insurance proffessional employed by Generic Family Practice. On September 7, 20xx, Emily Carson brought her 4-year-old son, Cory, to the office. Cory, who is complaining of ear pain and a sore throat, is new to the practice. Ms. Carson, a single mother, states that she and Cory are on Medicaid. After greeting Ms. Carson, what is the first thing you should do?
C. Brice Sammuels, a 9-year-old girl, come to Generic Family Practice on a monthly basic for follow-up treatment for a serve case of asthma. Gina Petter, a temp who is filling in for you during an absence, not that Brice was eligible for Medidcaid every month for the past 2 years. Assuming that Brice is eligible for Medicaid benefits on this visit, Gina neglects to verify current eligibility.
1. What, if any, possible problems could result from Gina’s failure to follow proper procedures?
2. If Brice’s visits have been covered by Medicaid for the past 2 years, what possible reason might there be for Medicaid to discontinue benefits?
Please answer Critical thinking questions A and B in Chapter 10 of the Health Insurance Today workbook. Put your answers into a Word document named “MilitaryPlansWorkbook” .
A. Patient Betsy Froman, who is enrolled in TRICARE standard, has been referred to you, the health insurance professional at Broamoor Clinic, with this question: ” I am scheduled for an outpatient echocardiogram at Broadmoor Meidcal Center next week. What, if anything, need to be done before I have this procedure?” What should you tell Ms. Froman? Will she need an NAS?
B. Assume that the Broadmoor providers are nonPars for military claims and require patients to file their own claims. Patient Arnold Chessworth, a CHAMPVA-eligible patient, asks you for help in getting filing information. Generate an instruction sheet for military patients on where to find this information: include online sources and toll-free telephone number.