The Patient Is Responsible for Payment When a Claim Is

question 43

Short Answer

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.

• 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.

Distinguish preventable causes of illnesses from other types and understand wellness programs' focus.

Conceptualize a comprehensive view of wellness programs, including their components and objectives.

Identify common relaxation techniques and their relevance to coping with job demands.

Understand the components of stress management and their implications for occupational health.

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Definitions:

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.