Describe ways a patient (or policyholder) can become involved in the process of disputing a payment decision made by his or her health plan.

What will be an ideal response?


The insured can directly contact the insurance company, either in writing or by telephone, and make an inquiry regarding reimbursement issues. In cases where there is good reason to pursue an issue with the state insurance commissioner, a letter can be prepared on behalf of the patient. The patient can also take reimbursement issues to her or his employer benefits department, and segek assistance at that level.

Health Professions

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Proprioceptive organ within the belly of skeletal muscles that is made up of 2–10 intrafusal fibers plus several types of sensory nerves encased in a spindle-shaped connective tissue capsule and embedded between extrafusal fibers; muscle

spindles register and respond to changes in muscle length and the speed of these changes.

Health Professions

Which of the following disadvantages of using an air ambulance should concern you the LEAST when utilizing it for a critically injured patient?

A) Aircraft cabin size B) Current weather conditions C) The cost that will be incurred D) The presence of uneven terrain

Health Professions

Which of the following is NOT a consideration when determining resource-based fee structures?

a. Work b. Practice expense c. Malpractice d. Extent of injury

Health Professions

Guillian-Barre syndrome affects

a. UMNs and LMNs b. Primary afferents and LMNs c. UMNs d. LMNs

Health Professions