Examlex
The patient is responsible for payment when a claim is denied in all of the following cases EXCEPT when:
A)services were for treatment of an excluded preexisting condition.
B)services were provided after coverage was canceled.
C)services were provided that were not preauthorized.
D)services were provided before coverage was in effect.
Agency and Structure
The dual concepts concerning an individual's capacity to act (agency) and the sometime constraining forces of social structure that influence that act.
Practices
Repeated actions or behaviors that are socially recognized within a particular culture or society, often seen as constituents of larger social systems or structures.
Norbert Elias
A sociologist known for his theory of the civilizing process, which explores how manners and social norms have evolved over time.
Civilization Process
The historical development of complex societies characterized by institutional structures, technological advances, and refined cultural norms, as theorized by Norbert Elias.
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