Healthcare reimbursement

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hcr202_v6_wk2_health_care_reimbursement_worksheet.docx

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HCR/202 v6

Health Care Reimbursement

HCR/202 v6

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Health Care Reimbursement

Complete Parts A and B of this worksheet.

Reference: Ch. 1 and Ch. 17 of Medical Insurance: A Revenue Cycle Process Approach (7th ed.)

Part A:

Pair the health care term from Column A with the appropriate definition from Column C. List the corresponding letter in Column B.

Column A	Column B	Column C
Co-pay	E	A. The amount owed for covered health care services before the health insurance plan begins to pay.
Deductible	A	B. The portion of charges an insured person must pay for health care services after payment of the deductible amount is met; usually stated as a percentage.
Out-of-pocket max	B	C. A patient who does not have insurance.
Self-pay patient	C	D. The most an insured person will have to pay for covered health care services in a policy period. Until this maximum amount is met, the health care plan and insured person share costs.
Co-insurance	D	E. A set dollar amount a health plan requires an insured person to pay at the time of service for each health care encounter.

Part B:

Resource: Table 1.2 in Ch. 1 of Medical Insurance: A Revenue Cycle Process Approach (7th ed.)

Describe three to four health plans by completing the following table. Be clear and concise, use complete sentences, and use in your own words.

Health Plans

Plan Type	Provider Options	Payment Methods	Features

Write a 50- to 150-word response to each of the following questions. Be clear and concise, use complete sentences, and explain your answers using specific examples.

1. How do provider options (network) affect reimbursement for patients?

2. Review the features of the plan types discussed in the table and identify what features are most important to a patient.

Cite any outside sources. For additional information on how to properly cite your sources, utilize the Reference and Citation Generator resource.