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Running head: Double Insurance 1
Double Insurance
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DOUBLE INSURANCE 2
Double insurance and Contribution
Question 1
Part 1
Nichols received payment from both BCBS insurance and secondary insurance. The
amount of payment received from BCBS insurance is Ksh $ 150 since this is the maximum
allowable amount being 100 % benefit. The amount received from the secondary insurance is
80% of the difference between the hospital visit charges and the maximum allowable amount,
which is 80% of (185-125) = $ 48.
Therefore, Nichol received a total of $ 150 + $ 48 = $ 198.
Part 2
The amount of money that ought to have been paid by BCBS is the allowable
amount less the copayment, which is:
$ 150 - $ 25 = $ 125.
Part 3
The amount to have been paid by Cigna, the secondary insurance company is 80%
of the difference between the hospital visit charges and the maximum allowable amount,
which is: 80% of $ 60 = $ 48.
Part 4
The insurance companies should have paid a total of $ 173. Instead, they ended up
paying a total of $ 198.
Part 5
Therefore, there was an overpayment of $ 25 by BCBS insurance which paid 100% of
the benefit.
Part 6

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Running head: Double Insurance 1 Double Insurance Student Name Institutional Affiliation Course Professor Date DOUBLE INSURANCE 2 Double insurance and Contribution Question 1 Part 1 Nichols received payment from both BCBS insurance and secondary insurance. The amount of payment received from BCBS insurance is Ksh $ 150 since this is the maximum allowable amount being 100 % benefit. The amount received from the secondary insurance is 80% of the difference between the hospital visit charges and the maximum allowable amount, which is 80% of (185-125) = $ 48. Therefore, Nichol received a total of $ 150 + $ 48 = $ 198. Part 2 The amount of money that ought to have been paid by BCBS is the allowable amount less the copayment, which is: $ 150 - $ 25 = $ 125. Part 3 The amount to have been paid by Cigna, the secondary insurance company is 80% of the difference between the hospital visit charges and the maximum allowable amount, which is: 80% of $ 60 = $ 48. Part 4 The insurance companies should have paid a total of $ 173. Instead, they ended up paying a total of $ 198. Part 5 Therefore, there was an overpayment of $ 25 by BCBS insurance which paid 100% of the benefit. Part 6 DOUBLE INSURANCE 3 After ascertaining that there was an overpayment of insurance claims by BCBS, I would seek to know if the overpayment was refunded. Nichols will already have sent a letter to the BCBS notifying the insurance company of the overpayment. Question 2 First, Nichols needs to pay for the o ...
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