Question

2) How do third-party payers notify insureds about the extent of playments made on a claim? What data elements does that notification include?

multiple choice

3) Cost sharing (out-of-pocket) costs for subscribers and patients

a) remain constant

b) are inceasing

c) are decreasing

Answer 1

Third-party payers notifies the insureds through a letter called Remittance Advice which contains the names of several patients with their account numbers. It has an explanation of benefits about the covered medical service and treatment of that particular patient. Pre-certification number, Practitioner number, Tax ID details, Check details and amount with payment and service date are there on the EOB statement.
Out-of-pocket costs for subscribers and patients are increasing.