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Managed care q a

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Surname 1
Name:
Tutor:
Course:
Date:
Managed Care
1. What types of costs are included in a patient's out-of-pocket expense?
Copayments
Deductibles
Coinsurance
2. List at least three reasons for contacting an insurance carrier to follow up on a
claim.
In case a claim has not been received.
To do a follow-up concerning an earlier claim that has been denied.
If there is some pending information
3. Explain what the medical specialist should do if the insurance carrier paid twice for
the same date of service and is requesting a refund.
In case an insurance carrier pays twice for the same date, the medical specialist should
first determine if the insurance truly made the overpayment. Then, the medical specialist
dealing with the situation should call the insurance carrier and request for an explanation
as to why it made the payment twice for the same date. The insurance carrier should also
be asked to reprocess the payment correctly and resend it before completing the refund.

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Surname 1 Name: Tutor: Course: Date: Managed Care 1. What types of costs are included in a patient's out-of-pocket expense? ✓ Copayments ✓ Deductibles ✓ Coinsurance 2. List at least three reasons for contacting an insurance carrier to follow up on a claim. ✓ In case a claim has not been received. ✓ To do a follow-up concerning an earlier claim that has been denied. ✓ If there is some pending information 3. Explain what the medical specialist should do if the insurance carrier paid twice for the same date of service and is requesting a refund. In case an insurance carrier pays twic ...
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