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Health Medical

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How is the patient responsibility portion of a bill factored into the contracted amount a physician agrees to accept for a specific service? For example, if a physician contracts with an insurance company to accept $100 for a specific service and the patient copay is $10, does the insurance pay $100 and the patient $10, for a total of $110? Assume there is no co-insurance such as 80/20 in this case, just a co-pay.

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overall input for week

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Running head: HEALTH INSURANCE

1

Health Insurance
Name
Course
Professor
Date

HEALTH INSURANCE

2
Health Insurance

Co-payment
The concept of co-payment, also referred to as co-pay, is an insurance concept that
involves the co-payment clause in the insurance policy. In such an agreement, the insured
person is obligated to pay a fixed amount of money, over and above the insurance premiums,
every time they access a health procedure or visit a physician. The concept is related to that
of co-insurance, with the difference only coming up in the fact that the insurance company is
mandated to pay a fixed amount for services rendered over and above the amount required
from the insured party in the event of a medical liability. In the case scenario provided, the
insurance company is under obligation to pay the $100 whereas the patient is also under
obligation to dispense with the $10, making the sum total for the payment to be $110.
Private payers/ACA plans
The chapter begins w...


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