ACA and Health Insurance

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  1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.
  2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.
  3. Consider the discussion and any insights you gained from it.
  4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

For this assignment, you create a PowerPoint Presentation discussion ACA and health insurance. Address the following questions in the presentation

  • Title slide
  • Discuss in your own words at least 2 advantages and 2 disadvantages to MCO’s (2-3 slides)
  • Discuss the specific characteristics of HMO’s (how are HMO’s different from other plans?) (2-3 slides)
  • Discuss the specific characteristics of  PPO’s (2 to 3 slides)
  • In your own words, explain how the Obamacare/Affordable Care Act has changed healthcare in America. (3-4 slides)
  • Show the case scenarios (below) (4-6 slides)

 In each case scenario that follows, calculate the financial responsibility of the patient and/or carrier and the discounted amount that the physician must write off. Show calculations and identify amounts. Students should complete each case on a separate slide. Students can place the questions on the slide, then provide the answers with calculations.

  1. Felix Grossman was seen today for an upper respiratory infection. Total charges for today’s services are $140. The allowed amount is $90. What are the discount amount and the amount the carrier pays to the provider?
  2. Emma Mastrangelo had a CT scan of the brain today because of recurrent migraines. Total charges are $720.50. Her benefits pay 90 percent of this procedure. The allowed amount is $462.60. What are the patient responsibility, discount amount, and the amount the carrier pays provider?
  3. Mabel Smith was seen in the office today for a checkup on her rheumatoid arthritis. Total charges are $85. The allowed amount is $52. She has a copay of $10. What is the discount amount, and the amount the carrier pays the provider?
  4. Rufus Durst had cholecystectomy performed today. Total charges are $2995.70. His benefits pay 60 percent of this procedure. The allowed amount is $1745.32. What are the patient responsibility amount, discount amount, and the amount the carrier pays? What amount will the physician write off?

For this section, ensure the information is referenced and cited in your slides. The presentation should start with a title slide and end with reference slides. If you include pictures, your pictures should also be referenced and cited.

Assignment Expectations:

  • Length:
  • Structure:
  • References:
  • Format:

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