HA 565 Unit 6 Discussion Reimbursements

HA565: UNIT 6DISCUSSION

Reading:Chapter 7:“Reimbursements”

Unit 6: REIMBURSEMENT – Discussion

Discussion

Imagine you are employed as an account professional in a health care organization. Which type of health insurance do you feel would be the most challenging to submit for reimbursement and in obtaining cooperation in obtaining payment?

So which is better?
In general, managed care plans are better suited for the average individual because they end up being more cost effective in the long run. In contrast, indemnity/reimbursement plans usually hit you with more out-of-pocket charges (in the form of deductibles and co-payments) and often place caps on the amount of benefits you can receive over your lifetime. Indemnity plans do give you more freedom, however, than managed care plans in terms of using the healthcare provider of your choosing. So, as with anything else, the choice between managed care and indemnity plans ultimately depends on your personal circumstances and preferences. If your goal is to minimize costs, you’re probably better off with a managed care plan. On the other hand, if your goal is maximum flexibility and cost is not a major factor, you should consider an indemnity/reimbursement plan.

Health reimbursement arrangements may be established by employers to pay employees’ medical expenses. A health reimbursement arrangement must be set up by an employer on behalf of its employees, and only the employer can contribute to it. The employer decides how much money to put in a health reimbursement arrangement, and the employee can withdraw funds from the account to cover allowed expenses. Health reimbursement arrangements often are established in conjunction with a high-deductible health plan, but they can be paired with any type of health plan or used as a stand-alone account.

http://www.agencyinfo.net/iv/medical/types/indemnity-managed.htm

http://archive.ahrq.gov/consumer/insuranceqa/insuranceqa5.htm

http://www.encyclopedia.com/topic/health_insurance.aspx

Use this one….for first response question

http://www.physicianspractice.com/review-article/economic-and-quality-life-outcomes-managed-care-perspectives/page/0/3

Professor and Class,

References:

Davis, Nadinia and LaCour, Melissa (2014). Health Information Technology, 3rd edition. Elsevier, Inc., St. Louis, Missouri

http://www.oregon.gov/oha/ohpr/hfb/delivery/reports/payment_reform_provider_reimbursement_paper_ohfb_final.pdf

http://www.bilozix.com/hcreimburesement.pdf

https://books.google.com/books?id=XbXwAwAAQBAJ&pg=PA353&lpg=PA353&dq=health+insurance+that+would+challenging+get+reimbursement+payment&source=bl&ots=RFFDvKH1kH&sig=HPwHkUZ4R2gVS5Ckt2sIsuUotb0&hl=en&sa=X&ved=0CFEQ6AEwCGoVChMI_suA0o2iyAIVxtCACh0Tjw2f#v=onepage&q=health%20insurance%20that%20would%20challenging%20get%20reimbursement%20payment&f=falsehttps://books.google.com/books?id=XbXwAwAAQBAJ&pg=PA353&lpg=PA353&dq=health+insurance+that+would+challenging+get+reimbursement+payment&source=bl&ots=RFFDvKH1kH&sig=HPwHkUZ4R2gVS5Ckt2sIsuUotb0&hl=en&sa=X&ved=0CFEQ6AEwCGoVChMI_suA0o2iyAIVxtCACh0Tjw2f#v=onepage&q=health%20insurance%20that%20would%20challenging%20get%20reimbursement%20payment&f=false