CASE STUDIES IN HEALTH INFORMATION MANAGEMENT:
Paper instructions:
Having listened to parts 1 and 2 of the lecture on chapter seven, please complete case study 2-34 found on page 143 of the case study text.
Please submit your work in the standard format established in the course.
Points will be assigned in the following manner:
6 points per each question
2 points for format, spelling, etc.
Case: Explanatzon of Benefits (EOB)
As patient advocate, you frequently receive questions from patienls regarding their bills. A patient culled today and asked you to explain a form that slur received {mm her insumncc company. Sim said the form was called an Explanation of Benefits. She said that it pmvidcd the inlbmmtion shown in the table below.
Table 2-20 Injbmmtion Found in Pafimtk Exfilmuuian (J Bmefiix
Provider: Dr. Theodore Simmons
Date: 11/11/2012
Type of service: . Office visit
Amount submitted: $82.00
Amount allowed: $74.00
Cainsumnce: $14.80
Deductible: $300.00
copay: $20.00
2oM Cengage uammg‘g. All Régms fiesnwed.
I. What would you say to explain what an Explanation of Benefits form is?
2. What would you say (a explain the difference between the amount submitmd and the amount allowed?
3. After you explain the (“Hermite between the amount submiued and the amount allowed to her, the patient gets irate and cxclaims, “How dare Dr. Simmons overcharge me by $8.00!” She then that she is guing to call his office and him a piece of her mind. What will you say in response?
3me – F‘ Elwin-mm Copyright 2013 Cengage Learning, All Rights Reserved. May not be copied. Scanned, or duplicated, in whole or in part.