Discussion Board Post:
Mrs. Thomas was on vacation out of state when she stepped off a curve and injured her left ankle. Due to severe pain she was seen at an urgent care center where she underwent a left ankle x-ray, which was negative. She was diagnosed with a left sprained ankle. A walking boot was provided to stabilize and protect her left ankle. She was provided with appropriate discharge instructions and instructed to follow up with her primary care physician upon returning home. When she presented her BlueCross BlueShield insurance card at check out, Mrs. Thomas was informed that the physician who provided treatment is a nonparticipating provider (nonPAR) and that the urgent care center accepts credit cards for payment in full. The total due was $1,500, and Mrs. Thomas assured the office staff that her insurance company would reimburse the urgent care center for services provided. The office staff further explained that their providers had not signed a contract with her insurance, and thus Mrs. Thomas was required to settle the bill upon discharge. The office staff suggested that her Blue Cross/Blue Shield insurance plan might reimburse Mrs. Thomas for the urgent care center encounter and that she would need to submit the invoice and claim to her insurance company.
Did the urgent care center’s office staff correctly describe their nonparticipating provider (nonPAR) status to Mrs. Thomas? Explain.
What are the requirements of a BCBS participating provider (PAR)?
What does BCBS agree to do for participating providers (PARs)?
Must be 250 words in APA format with two cited sources, will provide textbook information below
Textbook information
Green, Michelle A. Understanding Health Insurance: A Guide to Billing and Reimbursement,
2021 edition with MindTap Access. Cengage Learning. 2022. ISBN-13: 978-0-357-51562-4
Use the order calculator below and get started! Contact our live support team for any assistance or inquiry.
[order_calculator]