Health Care Reimbursement Worksheet

Health Care Reimbursement Worksheet 1 HCR/202 Version 3

University of Phoenix Material

Complete Parts A and B of this worksheet.

Reference: Ch. 1 and Ch. 17 of Medical Insurance

Part A

Pair the health care term from Column A with the appropriate definition from Column B. List the corresponding letter in Column C.

Column A Column C Column B

A. The amount owed for covered health care co-pay services before the health insurance plan begins to pay

B. The portion of charges an insured person must pay for health care services after payment of Deductible the deductible amount is met; usually stated as a percentage

Out-of-pocket max C. A patient who does not have insurance

D. The most an insured person will have to pay for covered health care services in a policy period. Self-pay patient Until this maximum amount is met, the health care plan and insured person share costs E. A set dollar amount a health plan requires an co-insurance insured person to pay at the time of service for each health care encounter

Part B

Resource: Table 1.2 in Ch. 1 of Medical Insurance

Describe three to four health plans by completing the following table. Be clear and concise, use complete sentences, and use in your own words.

Health Plans

Plan type Provider options Payment methods Features

Write 50- to 150-word responses to the following question. Use your own words and provide examples to support your answer.

Cite any outside sources. For additional information on how to properly cite your sources see the Referen ce and Citation Generator resource in the Center for Writing Excellence.

1. How do provider options (network) impact reimbursement for patients?

2. Review the features of the plan types discussed in the table and identify what features are most important to a patient.