Valley Hospital previously.

Valley Hospital previously.

The Case Studies Activity must be submitted as a Microsoft Word document.

Case Study 2

Mr. Jones is seen in the ER at Grand Valley Hospital for chest pain. He is from another state and is visiting family. He has never been to Grand Valley Hospital previously.

While in the ER, it is determined that the patient needs a cardiac catheterization done before discharge. This procedure is performed by Dr. Lindsay.

Mr. Jones serves in the National Guard and has been covered by TRICARE since 1989. He is also covered by his employer’s health plan, Blue Cross Blue Shield, and has been covered by this health plan for the past 2 years.

Based on the information in this case study, determine if this is a new or established patient. Then, describe what information you will need to collect from the patient and what steps you must take to ensure the services being rendered will be covered by insurance. Determine which insurance policy is primary.

Case Study 3

Jack Minnow, a 4-year-old boy, presents to Valley Allergy practice because of a recent allergic reaction to a bee sting. He has never had a reaction previously. Jack’s primary care physician Dr. Zane is referring him to Dr. Shelby, an allergist, for a consultation. Jack is accompanied by his mother who is the custodial parent.

During the visit, Dr. Shelby performs a series of allergy tests that identify not only an allergy to bees, but also to animal dander and grass.

Jack is covered by both his mother’s and his father’s employers’ health plans. His parents are divorced. His mother went back to work after the divorce 1 year ago and enrolled Jack under her health plan due to some concerns about whether Jack’s father would keep his job. However, his father is still employed with the same company and has worked there for the past 3 years.

Based upon the information in this case study, determine if this is a new or established patient. Then, describe what information you will need to collect from the patient/guarantor and what steps you must take to ensure the services being rendered will be covered by insurance. Determine which insurance policy is primary.