Author Question: A health care practice has changed its mix of patients and now accepts fewer self-paying and more ... (Read 131 times)

karen · **on:** Jul 22, 2018

A health care practice has changed its mix of patients and now accepts fewer self-paying and more insured patients. The office manager tells the staff to anticipate

a. caring for more-educated patients.
b. offering expanded office hours and days.
c. ordering more diagnostic tests.
d. providing more preventive care.

Question 2

An insurance company's internal statistics show that the company is losing a great deal of money processing small, frequent claims submitted by its customers. The company accountant suggests that the best way to decrease this loss is to

a. delay payment until the claims reach a set figure.
b. educate customers on how much these claims cost.
c. increase the deductible customers must satisfy.
d. refuse to accept claims below a certain amount.

karmakat49 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

C
When consumers carry health insurance, they become insulated from the cost of medical care, and the demand for health care services increases.
Insured patients are not necessarily more-educated patients.
Having more insured patients does not necessarily translate into the need for expanded hours and days of operation.
Insured patients generally demand more health care services of all types, not just preventive care.

Answer to Question 2

C
Deductibles and co-payments are types of cost sharing used by most insurers. Deductibles are designed to persuade customers to make better decisions about care and to dissuade them from submitting small claims.
Delaying payment until the claims reach a set figure might serve to annoy customers, who then might choose another insurer. This approach might also cost more because someone would have to track the claims.
There probably is not an effective way to educate perhaps millions of customers enough to dissuade them from submitting claims for reimbursements or payments they are owed.
Refusing to accept claims below a certain amount would probably be an unpopular action, perhaps leading to customers switching insurance companies.