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\u00a0<\/p>\n

Students will complete the following scenario as an essay.<\/p>\n

As you are completing your audits you observe Mary Johnson\u2019s chart and notice the following:<\/p>\n

Mary Johnson saw Dr. Nichols today for a well-woman exam. Total charges are $185.00. Mary has two insurance companies:<\/p>\n

Primary Insurance<\/p>\n

Secondary Insurance<\/p>\n

BCBS<\/p>\n

Cigna Health Care<\/p>\n

Copay: $25.00<\/p>\n

Deductible: $200.00 (already met)<\/p>\n

100% benefit after copay<\/p>\n

80% benefit after deductible<\/p>\n

Allowed amount: $150.00<\/p>\n

Allowed amount: $125.00<\/p>\n

Both claims were submitted at the same time in error.<\/p>\n

Money collected from the patient: $0.00<\/p>\n

    \n
  1. Complete the following questions providing rationales for your responses:\n
      \n
    1. How much money did Dr. Nichols receive?<\/li>\n
    2. How much should BCBS have paid?<\/li>\n
    3. How much should Cigna have paid?<\/li>\n
    4. How much is this claim overpaid?<\/li>\n
    5. Who overpaid on this claim?<\/li>\n
    6. What would be your next steps?<\/li>\n<\/ol>\n<\/li>\n
    7. Address how this situation might be avoided in the future: be specific and provide steps.<\/li>\n
    8. The well-woman exam showed this patient due to family history of cancer would benefit from BRCA genetic testing and both insurance companies denied this claim. Format a letter of appeal or BRCA testing.<\/li>\n<\/ol>\n

      This assignment is completed as an APA style paper, and should be at least 2-3\u00a0pages in length. Demonstrate your business knowledge and professional ethics in your response.<\/p>\n

      Assignment Expectations:\u00a0\u00a0<\/em><\/p>\n