Question

23. Why is it important to understand the differences among the different types of healthcare plans?

24.What happens if a capitated patient’s account was not adjusted to a zero balance?

25. What is the purpose of reviewing a remittance advice before enterning payments and adjustments?

Answer 1

23. There are many different kind of health insurancr plans available in the market. Each plan has its own cost and benefits. It is important to understand differences among the healthcare plans so that the individual can choose a plan best suitable to him. Understanding different healthcare plans will help him compare the different costs and benefits of these plans and select a plan that best fits the budget. Understanding the merits and demerits of healthcare plan will help in opting for the plan that best suits the individual and his family needs.

24. charges need to be adjusted for patients who are covered under capitated insurance plan to imply that the insurance company has met its obligation and the patient has paid the co-payment.

If a capitated patient account was not adjusted to a zero balance it means they would still have payments on their charges.

25. The purpose of reviewing a remittance advice before entering payments and adjustments is to review the payment amount against the expected amount.