Asked by annissa official on Jul 17, 2024

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The patient in the ambulatory clinic asks the nurse in the billing office,"Why do I have to pay $10.00 for this visit when I have insurance?" What is the nurse's most appropriate response?

A) "I don't know how your insurance works. You need to pay this and follow up with your insurance company."
B) "This a co-payment you are required to pay per clinic visit as described in your insurance plan."
C) "Healthcare is expensive and insurance companies can't pay all of the costs."
D) "This is part of your insurance premium that you pay monthly."

Co-payment

A fixed amount paid by a healthcare insurance policyholder for services, such as a visit to the doctor or prescription drugs, with the rest covered by the insurance company.

Insurance Premium

The amount of money that an individual or business must pay for an insurance policy, typically charged monthly or annually.

Billing Office

A department within a healthcare facility responsible for processing patient billing and insurance claims.

  • Assess the distinctions among different forms of managed care and health insurance schemes.
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Cameron Crosswell

Jul 22, 2024

Final Answer :
B
Explanation :
Those who have insurance or government-financed insurance bear some of the expenses of healthcare through cost sharing.Typical cost sharing can be in the form of co-pays,deductibles,paying a portion of one's insurance premium,or paying costs above a fixed payment amount.Patients do not always understand cost-sharing methods and may need an explanation at the time of the visit.The best response is for the nurse to explain what a co-payment is.Most facilities have access to the coverage plan and can answer immediate questions until the patient is able to follow up with his or her insurance company.Stating that healthcare is expensive is merely stating the obvious; it may also be perceived as defensive rather than supportive.Co-payments are typically not part of an insurance premium and are only collected at the time of a service.