Fundamentals of Medical Insurance

Describe the difference between Original Medicare and Medicare Advantage plans.

Explain why it is useful for patients to understand their coverage, limitations, and exclusions, as well as financial responsibilities, as they relate to medical insurance coverage.

When comparing indemnity plans to HMOs, PPOs, and POS plans, which one offer.

• More flexibility in terms of access to health care?  Explain your answer.
• Lower out-out-pocket costs?  Explain your answer

Discuss some of the advantages and disadvantages of Health Reimbursement Arrangements (HRAs).

The physical has rendered services to a new patient at the hospital.  The only information available is the patient’s name, location, and diagnosis.

• Describe some examples where patient information can be obtained for registration and medical billing purposes.
• Explain the requirements of HIPAA for requesting and using information from medical providers and facilities.