If a Third Party Is Responsible for Injuries to a Plan

question 82

Multiple Choice

If a third party is responsible for injuries to a plan member of the Hope Health Plan, then Hope has a contractual right to file a claim for the resulting healthcare costs against the third party. This contractual right to recovery from the third party is known as

• A) Subrogation
• B) Partial capitation
• C) Coordination of benefits
• D) Aremedy provision

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Definitions:

Perforation

A medical term referring to a hole that develops through the wall of a body organ.

Hemorrhage

The escape of blood from a ruptured blood vessel, leading to bleeding either inside or outside the body.

Bile Duct

The pathways through which bile flows from the liver to the small intestine, aiding in the digestion of fats.

Chronic Cholangitis

Long-term inflammation of the bile ducts, which can lead to scarring, liver damage, and other complications.