A patient is confused about how to make payments for a recentvisit to urgent care and hospital stay. Her employer-basedinsurance provider's website allows her to use her HSA account tomake a payment online. She uses her HSA debit card to make thepayment, but her insurance provider sends her a check instead ofsending it to the Tri-City HealthCare Agency. After contacting herinsurance help desk via the website, she is told to send the checkto Tri-City HealthCare Agency herself. The patient asks theinsurance provider's help desk representative why they cannot justmake the payments for her. She is told about the various paymenttypes and payers in the health care industry and how the marketinfluences the integrated delivery systems in the industry.
Case Questions
1. Describe the payer systems mentioned in the case study.
2. Explain how the market forces have influenced the need forintegrated delivery systems.
3. How might the insurance provider explain the payment systemit utilizes for its clients? Explain if this method is effective ornot for the insurance provider's clients.
4. What has been the most significant legal and regulatoryeffect on managed care organizations?
5. How would this case study have differed if the patient wasusing public or social insurance?
A patient is confused about how to make payments for a recent visit to urgent care and hospital stay. Her employer-based
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A patient is confused about how to make payments for a recent visit to urgent care and hospital stay. Her employer-based
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