Chapter 3 Applying Your Knowledge

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Big Sandy Community and Technical College *

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204

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Medicine

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Apr 3, 2024

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docx

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4

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1. Case 3.1 Abstracting Insurance Information Carol Viragras saw Dr. Alex Roderer, a gynecologist with the Alper Group, a multispecialty practice of 235 physicians, on October 24, 2027. On December 3, 2029, she made an appointment to see Dr. Judy Fisk, a gastroenterologist also with the Alper Group. Did the medical insurance specialist handling Dr. Fisk’s patients classify Carol as a new or an established patient? Short Answer New patient Short Answer Edit Unavailable New patient Group Ends Explanation new patient Carol Viragras is considered a new patient since she is being seen under a new specialty. 2. Case 3.2 Documenting Communications Harry Cornprost, a patient of Dr. Connelley, calls on October 25, 2029, to cancel his appointment for October 31 because he will be out of town. The appointment is rescheduled for December 4. How would you document this call? Short Answer Patient Name: Harry Cornprost Date of Call: 10/25/2029 Topic: Reschedule appointment with Dr. Connelley Outcome: Appointment rescheduled for 12/4/2029 Short Answer Edit Unavailable Patient Name: Harry CornprostDate of Call: 10/25/2029Topic: Reschedule appointment with Dr. ConnelleyOutcome: Appointment rescheduled for 12/4/2029 Group Ends Explanation Patient Name: Harry Cornprost Date of Call: 10/25/2029
Topic: Reschedule appointment with Dr. Connelley Outcome: Appointment rescheduled for 12/4/2029 3. Case 3.3 Coordinating Benefits Note: this question will not be automatically graded. It will be sent to your instructor for review. Based on the information provided, determine the primary insurance in each case. A. George Rangley enrolled in the ACR plan in 2018 and in the New York Health plan in 2016. George’s primary plan: Essay 1Edit Unavailable.New York Health Plan B. Mary is the child of Gloria and Craig Bivilaque, who are divorced. Mary is a dependent under both Craig’s and Gloria’s plans. Gloria has custody of Mary. Mary’s primary plan: Essay 2Edit Unavailable.Gloria's plan C. Karen Kaplan’s date of birth is 10/11/1985; her husband Carl was born on 12/8/1986. Their child Ralph was born on 4/15/2015. Ralph is a dependent under both Karen’s and Carl’s plans. Ralph’s primary plan: Essay 3Edit Unavailable.Karen's plan D. Belle Estaphan has medical insurance from Internet Services, from which she retired last year. She is on Medicare but is also covered under her husband Bernard’s plan from Orion International, where he works. Belle’s primary plan: Essay 4Edit Unavailable.Bernard's plan (or Orion's plan) E. Jim Larenges is covered under his spouse’s plan and has medical insurance through his employer. Jim’s primary plan: Essay 5Edit Unavailable.Jim's employers plan Explanation A. New York Health B. Gloria’s plan C. Karen’s plan D. Bernard’s plan (or Orion’s plan) E. Jim’s employer’s plan
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