Question

In: Nursing

Instructions This week we looked into refunds and appeals, the other side of the payment and...

Instructions

This week we looked into refunds and appeals, the other side of the payment and accounting process, which are just as important as submitting claims successfully.

  1. Refer to Chapter 17 of the textbook to understand the rules and regulations for full payment and wait times.
  2. Then, discuss the following questions:
    • Who is responsible for the payment for a worker’s compensation case?
    • Why are separate medical record necessary for these cases?

Solutions

Expert Solution

Ans-1)the employees pay the premium as monthly or according to claims in insurance company.and insurance company check what are the benefits and the pay to the injured Patient.the injured Patient have benefits of Patient compensation claim benefit.

If you are worker and you received the compensation benefits, the company from which you receive your workers compensation benefits may or may not be your employer. It may be your state government, the insurance company, your employer, or the third party administrator hired by your employer to be responsible for administering the employer’s workers compensation claims.

2)in the case of insurance claims the cases are legal and insurance companies proceed after checking every minute details.

Insurance companies are use the medical records of the patient to verify the injury before they approved the additional treatment.if they doesn't show any damages, injury or severity in case deny the payment of Patient.

Insurance companies are find the medical data in regarding to your past history regarding to medical condition.insurance companies used this data to argue with patients that the medical injury are not related to accident and suspend or reject the compensation claims of worker.

That why separate medical records are Nessesary for this type of cases.


Related Solutions

The discussion for this week will focus on the complexities of refunds, follow-ups, and appeals.
The discussion for this week will focus on the complexities of refunds, follow-ups, and appeals.After reading Chapter 16 of your text, open the website www.appealsolutions.com. Once there, spend some time searching through all the parts of the website.In your own words, explain why such a website is necessary in order to run a successful physician practice.NOTE: Please this is the book for the class. From page 489 to 490Comprehensive Health Insurance 3rd EditionDeborah Vines; Ann BracelandElizabeth Rollins; Susan Miller.
This week, you have read about the rhetorical appeals of credibility, reason, and emotion and the...
This week, you have read about the rhetorical appeals of credibility, reason, and emotion and the role of information literacy in responsible research. For your initial post this week, find a current event article from a reputable news outlet and provide an academic summary. In your summary, you must include the following. A summary of the central idea or argument of the article An explanation of the topic An analysis of how the appeals of credibility, reason, and emotion operate...
With NPV and the other Capital Budgeting methods we are discussing this week they all consider...
With NPV and the other Capital Budgeting methods we are discussing this week they all consider quantitative factors or numbers when deciding on an investment/project.  What are some non quantitative factors or qualitative factors that also need to be considered (even if I was a former bean counter I do not believe you can put everything into numbers).
8. We revisit the case of Marcel and Yvonne that we looked at in an earlier...
8. We revisit the case of Marcel and Yvonne that we looked at in an earlier tutorial topic relating to the parol evidence rule and collateral contracts. Here are facts: Marcel wants to buy a used car. He knows the make, model and colour of the car he wants to buy. He visits several car dealers who can supply the type of car he wants. In discussions with one dealer, Yvonne, she tells Marcel that if he buys the car...
1) Aris uses a boat to cross from one side to the other side of a...
1) Aris uses a boat to cross from one side to the other side of a river of width w = 32 m. The river flows at VC = 8 m/min. and he can row at a speed of VB =30 m/min. in still water. He wants to land at a dock which is L=10 m downstream from a point directly opposite his starting point. a) In what direction (i.e. angle relative to the bank), should he aim his boat...
Homework 9 Previously you looked at WalMart's failure in Germany. This week, let's look at a...
Homework 9 Previously you looked at WalMart's failure in Germany. This week, let's look at a successful US multi-national - McDonald's. Find and summarize an article discussing how McDonald's has been so successful in developing markets...specifically look at the Soviet Union in the 80's or China more recently.
Find a poet who appeals to you from a culture other than your own in our...
Find a poet who appeals to you from a culture other than your own in our text Compact Literature. Why does his or her work appeal to you? Explain your ideas and feelings so that your colleagues can understand why you have chosen this particular author. *Note that the poet that you choose to discuss in this posting should come from a culture that is different from your own. You need to explain those differences and how they are reflected...
Side Panel Expand side panel Breadcrumb: Week 2 Discussion     The Research Process Imagine you...
Side Panel Expand side panel Breadcrumb: Week 2 Discussion     The Research Process Imagine you are in a fast-food restaurant where a lady tells you that she had heard there was a gene for liking or hating the taste of cilantro. You looked on the Internet to investigate this statement, and although you found similar comments on reputable websites, you are yet to find any scientific studies supporting this claim. Should you be skeptical about the scientific merit of...
I have looked at other answers on here in regards to this question. But I do...
I have looked at other answers on here in regards to this question. But I do not know what "In" stands for and those who answer are using different descriptions than I am used to. Here is the question. Number of Periods. How long will it take for $400 to grow to $1,000 at the interest rate specified? (LO1) a. 4% b. 8% c. 16%. Could someone please break this down a little further for me.
In this week's reading we looked at accounts, identity, authentication, and account recovery. There is an...
In this week's reading we looked at accounts, identity, authentication, and account recovery. There is an old adage that says, "You can never be too safe. When it comes to the digital world, it's very true. Cyber hackers and hijackers are lurking everywhere to steal digital information. And while it's a piece of cake for them to get passwords and other sensitive information, for the rest of us, keeping track of login information is a hassle especially since everything needs...
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT