Question
I only need the drawn diagram Diagram B 10 points Draw a diagram explaining and labeling Healthcare Transaction B . Healthcare Transaction B : Peter
I only need the drawn diagram
Diagram B
10 points
Draw a diagram explaining and labeling Healthcare Transaction B.
Healthcare Transaction B:
Peter works with Corporation X and is covered under Corporation X's health plan (assume Peter pays no monthly premiums). Corporation X's health plan is a self-insured plan. Corporation X pays TPA Services, a third-party administrator, to handle Corporation X's health plan.
Peter goes to the doctor once to get service. The total cost for the physician's service was $60,000. The insurance terms are:
- $50 co-pay per visit.
- $500 deductible (assume co-payment counts toward deductible).
- After the deductible, co-insurance is 80/20:
- 80% insurance company; and
- 20% patient.
- A maximum out-of-pocket provision of $8,000
Do the following:
(1) Explain what parties bear economic risks in Healthcare Transaction B.
(2)Label each party, the directionality of the money and services, and the exact amount associated with each term (e.g., co-pay) above (see the examples below).
You do not have to draw the diagram using software (e.g., Word, Power Point); you can do it using pen and paper (as long as it is legible). If you use pen and paper, please take a picture or scan the document and upload it to Blackboard.
Diagram Example:
Example of a diagram where the patient is uninsured and pays 100% out-of-pocket for a medical visit where the total cost of services is $100.
$100
PETER DOCTOR
Service
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