2023 Students will complete the following scenario as an essay As you are completing your audits you
Nursing 2023 Healthcare Reimbursement
2023 Students will complete the following scenario as an essay As you are completing your audits you – Course Fighter
Students will complete the following scenario as an essay.
As you are completing your audits you observe Mary Johnson’s chart and notice the following:
Mary Johnson saw Dr. Nichols today for a well-woman exam. Total charges are $185.00. Mary has two insurance companies:
Cigna Health Care
Deductible: $200.00 (already met)
100% benefit after copay
80% benefit after deductible
Allowed amount: $150.00
Allowed amount: $125.00
Both claims were submitted at the same time in error.
Money collected from the patient: $0.00
- Complete the following questions providing rationales for your responses:
- How much money did Dr. Nichols receive?
- How much should BCBS have paid?
- How much should Cigna have paid?
- How much is this claim overpaid?
- Who overpaid on this claim?
- What would be your next steps?
- Address how this situation might be avoided in the future: be specific and provide steps.
- The well-woman exam showed this patient due to family history of cancer would benefit from BRCA genetic testing and both insurance companies denied this claim. Format a letter of appeal or BRCA testing.
This assignment is completed as an APA style paper, and should be at least 2-3 pages in length. Demonstrate your business knowledge and professional ethics in your response.
- answers must thoroughly address each question in a clear, concise manner; complete answers will likely take 2-3 pages
- Title and reference page required
- address each question in a numbered list
- References required to be cited if used
- Click the “Order Now” button to reach our online order form. Share your requirements (word count, deadline, topic, referencing style, etc.) and submit them.
- Pay via PayPal, credit card, debit card, or online banking with our reliable gateway. We provide 100% secure transfer.
- One of our certified writers will work on your assignment and deliver it to your registered email ID along with a free “Plagiarism Report” to prove the originality of the work.