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Lesson 11 Forum - Team 1

Lesson 11 Forum - Team 1

Q This forum is two parts! Please complete both (they don't have to be in one single post though). Part 1: EOBs You frequently get questions from patients regarding their bills. A patient calls today and explains a form she received from her insurance company (the Explanation of Benefits). She indicated that it contained the following information: Provider: Dr. Mary Smith Date: 01/01/2013 Type of Service: Office Visit Amount Submitted: $90.00 Amount Allowed: $80.00 Deductible: $300.00 Copay: $20.00 How would you explain to this patient what an EOB form is? How would you explain the amount allowed and what the copay is? Part 2: ABNs Review the links in the module (right below the L3 Forum) "ABN Form" and "Instructions for ABN Form." Then open the document titled "ABN Form Completed." Analyze this completed form and answer the following: *What pieces of the document are not completed correctly? *Describe what could happen because of errors on the ABN form. Any questions concerning this lesson or the textbook material should be posted to the link titled Ask Questions About L11 Here. I actively monitor that forum for student questions. Please do not request quiz answers or clarification to quiz answers until AFTER the quiz has closed, and you have had a chance to review the correct answers. If, after you have seen the correct answers you still have questions, you may post them to the link titled Ask Questions About L11 Here. To add your post, click on the L11 Forum link below. From there, you will see a reply button. Once you post your reply, you have 30 minutes in which to edit your reply. When the 30 minutes have passed, you will be able to see the posts made by your classmates.

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An EOB is a statement showing a person’s health insurance plan and describing the costs that the insurance will cover. The EOB is produced when the insurance provide receives a claim for services a patient has received. The EOB is sent to ensure the cost of care is clear and well understood, to ensure the patient understands money the insurance covers and money they are supposed to pay out of their pocket after the insurance has paid. The amount allowed is the total amount that the health insurance company thinks the health institution where a patient is should be paid. The Copay section indicates the amount that one pays for a health care service that is covered by one’s insurance. Copays are different from different health care services