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Scenario One: An 86-year widow comes in monthly to have her blood drawn and monitored ever...

Scenario One: An 86-year widow comes in monthly to have her blood drawn and monitored ever since her heart attack 2 years ago. Her husband has recently passed away and she has no family nearby to help her. She has Medicare but does not have supplemental insurance to cover office visits. When leaving the office today, she starts to cry and tell you that she can no longer afford her blood pressure medications, cholesterol medications, blood work, and office visits each month. She will not be able to get her medications refilled unless she sees the doctor and has blood work each month. She currently owes $180 on her account today.

Scenario 2: A 19-year-old mother of 3 children, all under the age of 5, brings in all of the kids today for their recommended check-ups and vaccinations. She does not have insurance for any of the children as she was denied Medicaid based on a previous fraud. She has been diligent paying for the children’s healthcare, with assistance from a grandmother, but she recently passed away. After today’s visits, she tells you that she only has enough money to pay for services for two of the kids, but not the third one. This mother has been known to cause scenes and be disrespectful to the office staff, and you know that if these children are discharged from the office, they will have a hard time being accepted at another provider due to the mother’s behavior.

  1. How would you handle each of these situations?
  2. Is one scenario worthy of breaking the official rules? One more than others?
  3. If you must discharge these patients for non-payment, what advice will you give them?
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Answer #1

1. How would you handle each of these situations?

Take the time to properly handle the elderly patient and to assure her understanding and continued medical care in order to best protect her.

Screening to determine the eligibility of a child to receive vaccines through any free VFC program, and the screening results must be documented with each vaccination visit. The patient eligibility screening report includes a way to document parent answers to questions about eligibility for VFC.

2. Is one scenario worthy of breaking the official rules? One more than others?

Yes we can in case of Scenario 1 , because of her personal and financial conditions, where as in in scenario 2 because of her earlier behavior the rules breaking will not be given any value.

3. If you must discharge these patients for non-payment, what advice will you give them?

In case of scenario 1 We have to advice her about , the care she has to take about her health and medications that has to be administered in timely manner to protect her helath.

In case of Scenario 2 , she has to be advised about time of vaccinations and their importance.Any hospitals organizing these programmes freely for children has to be enlightened.

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