Ask Experts Questions for FREE Help !
Ask
    allbrainnomuscl's Avatar
    allbrainnomuscl Posts: 2, Reputation: 1
    New Member
     
    #1

    Nov 2, 2018, 04:58 PM
    In USA If A Prctitioner Cause Cost More Than Allowed By Insurance Company
    In USA If A Prctitioner Cause Cost More Than Allowed By Insurance Company For Example Orders Hospitilizing A Patient More Than Period Allowed By Insurance Who Have To Pay Extra Cost
    A.patient
    B.practitioner
    C. Insurance Company But Their Would By Some Punishment For Practitioner


    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,277, Reputation: 7690
    Expert
     
    #2

    Nov 2, 2018, 06:48 PM
    This appears to be a test,

    But it is good to know, and I am shocked you don't know it.

    The patient has to pay.
    The insurance company only pays what it has to by policy
    The doctor is due his pay.

    Only exception is normally medicare, where the price is normally set by contract.
    allbrainnomuscl's Avatar
    allbrainnomuscl Posts: 2, Reputation: 1
    New Member
     
    #3

    Nov 3, 2018, 06:13 AM
    Thank.
    The C. Option typo correction : " ... There would be some punishment for practitioner"
    I don't live there but like to know your system.
    So the doctor get paid. Does it means nothing will discourage unnecessary treatments unless the patient cannot afford it
    talaniman's Avatar
    talaniman Posts: 53,910, Reputation: 10852
    Expert
     
    #4

    Nov 3, 2018, 09:11 AM
    Define unnecessary. You can report duplication of services, or request an EXPLANATION of any procedure they prescribe, including follow ups. Keep in mind all health insurance here is 80/20 at best, so expect those out of pocket expenses, unless you have SUPPLEMENTAL insurance. Most doctors I have dealt with are open to PAYMENT arrangements for those out of pocket expenses.

    It comes down to being INFORMED about your policy, state law, and your doctor's network policy if they are part of one. Most Americans are covered under employer sponsored insurance, in which part of your premiums are paid by your job, the rest have no such discount thus higher premiums, co pays, and deductibles. Yes expensive.
    Wondergirl's Avatar
    Wondergirl Posts: 37,769, Reputation: 5427
    Jobs & Parenting Expert
     
    #5

    Nov 3, 2018, 10:00 AM
    Does it means nothing will discourage unnecessary treatments unless the patient cannot afford it
    It is the patient's responsibility to not only question his practitioner as to proposed treatments and how they will affect the patient but also the patient needs to do his own research in reliable sources (medical journals, second and third opinions from other physicians, reliable medical websites) about his illness and possible treatments. In other words, a patient must be fully informed and be his own best advocate -- for his health's sake as well as for the sake of his finances.

    The patient always has the right to refuse a treatment.
    Brownknows's Avatar
    Brownknows Posts: 1, Reputation: 1
    New Member
     
    #6

    Jan 3, 2019, 06:41 PM
    In general, payment of the balance is the patient's responsibility. However, if the care was rendered through a "managed care" arrangement (such as a health maintenance organization), state law may not permit "balance billing." The reason is that when the provider enrolled to be a provider to members of the HMO, he/she agreed to accept as full payment that which the managed care organization allowed.

Not your question? Ask your question View similar questions

 

Question Tools Search this Question
Search this Question:

Advanced Search

Add your answer here.


Check out some similar questions!

Insurance company sennding my medical info to another company [ 4 Answers ]

My question is a insurance company sent my full name, social sercurity number and all my info concerning my short term disability claim to a third party on accident, is this a hipaa violation? They did send me a letter but offered nothing about what to do about it as far as my identity being stolen...

The Patrick Company's cost of common equity is 16%, its before-tax cost of debt is 13 [ 1 Answers ]

10-9 WACC. The Patrick Company's cost of common equity is 16%, its before-tax cost of debt is 13%, and its marginal tax rate is 40%. The stock sells at book value. Using the following balance sheet, calculate Patrick's WACC. Assets Liabilities and Equity Cash $ 120 Accounts receivable 240 ...

A company insurance salesman sold a life insurance policy to a client for a premium o [ 1 Answers ]

A company insurance salesman sold a life insurance policy to a client for a premium of $25,000. The agency billed the client for the policy and is entitled to a commission of 20%. How do I do an adjusting journal entry for this question? Will it have two parts to it?

Looking for insurance policy no 9929780 insurance company he have [ 2 Answers ]

Prairie land/federated insurance campany ineed to get this insurance campany

Insurance Company fired pregnant worker for missing days, but those days were allowed [ 1 Answers ]

Is it legal for the same employer to keep an employee that has been terminated on their payroll, in order to refrain from paying out unemployment benefits?


View more questions Search