Personal Definition

Question 1

This should bring up the article.

Whaley, C., Schneider Chafen, J., Pinkard, S., Kellerman, G., Bravata, D., Kocher, R., & Sood, N. (2014). Association between availability of health service prices and payments for these services. JAMA: Journal of the American Medical Association, 312(16), 1670.

Scenario:

M. Harley recently began a new job as the accounting manager for a local medical clinic. A billing statement has just been received from Galaxy Labs, one of several such labs that perform tests for the clinic. M. Harley notices that the lab charges the clinic $30.00 for a standard blood test. The clinic, however, bills patients or their companies $120 for the test. The $120 is the standard insurance reimbursement paid on behalf of the patient. Therefore, the clinic is profiting on every blood test ordered.

After additional investigation, M. Harley finds similar mark-ups on other lab tests. M. Harley is concerned about this billing practice and suspects the clinic may have selected the lab based on low cost rather than on the lab’s qualifications. Another concern would be the accuracy of all lab test results.

M. Harley also wonders if profit potential is motivating doctors to order unnecessary tests.

Question 2

The purpose of this assignment is to help you understand the types of patient consent and what role they play in the health care industry. It is important also to understand the legal issues and laws that regulate third-party payers.

Complete the Types of Consent and Payers Chart.

Cite 2 peer-reviewed, scholarly, or similar references to support your paper.

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