Preview

Case Study: Can Aetna Help You Pay For Rehab

Good Essays
Open Document
Open Document
421 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Case Study: Can Aetna Help You Pay For Rehab
Can Aetna Help You Pay For Rehab? One of the little know facts about healthcare insurance plans is that they are now required to cover addiction treatment services as though addiction were like any other type of medical condition. This edict was provided by provisions in the Affordable Care Act (ACA). While Aetna covers drug rehab, the amount of your coverage may vary based on the type of policy you selected when you purchased the insurance.

About Aetna
Aetna is truly a national healthcare insurance provider. With over 23 million Americans currently on its medical insurance rolls, the company provides its service in all 50 states. They offer both corporate and individual plans that include basic medical and dental benefits, disability and


You May Also Find These Documents Helpful

  • Good Essays

    As my MBA concentration is in General Business and Finance the most relatable to my…

    • 767 Words
    • 4 Pages
    Good Essays
  • Good Essays

    This firm represents North Texas Division, Inc. and its affiliated facilities, including Medical City Dallas Hospital (“Medical City”). Reference is made to the Medicare Advantage Facility Participation Agreement (eff. October 30, 2010) as amended (collectively, the “Agreement”). I write regarding SelectCare’s failure to appropriately adjudicate a claim by Medical City for services provided to patient E.F. By this letter, the Hospitals invoke all dispute resolution procedures permitted or required under the Agreement.…

    • 802 Words
    • 4 Pages
    Good Essays
  • Good Essays

    As a resolution analyst at UnitedHealthcare (UHC), over ninety percent of my decisions are based on evidence provided by providers’ and members’ health policy contract and UHC reimbursement policies. The health policy contract provides payment regulations on how to correctly make a decision of either a claim is to be denied, paid or if additional steps are required. In a case where a member is asserting that an out-of-network provider should be reimbursed in-network based on their research involves investigating beyond the member’s contract and UHC reimbursement policies to justify an overturn. If the member provides proofs such as a copy of the participating provider listing on UHC's website or the provider proper Tax ID to support their…

    • 286 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    1- How could his physician’s office have prevented this problem? I think that the physician with it avoid this situation if they have Communication this is the most important point for a successful resolution of this kind of problem .…

    • 112 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    And if you have a Health Savings Account or HSA, you should know that you can pay for your drug rehab using the funds that you have in your account.…

    • 1054 Words
    • 5 Pages
    Good Essays
  • Satisfactory Essays

    From these chapter I have gain the knowledge of know, the delivery of health traditionally evolved around the individual relationship between the provider and patient/consumer. The payment was either provided by a health insurance company or paid out of pocket by the consumer. This fee-for-service system or indemnity plan increased the cost of healthcare because there were no controls on how much to charge for the providers service. As healthcare costs continued to spiral out of control throughout the decades, more experiments with contract practice and prepaid service occurred randomly across the U.S. healthcare system (Shi & Singh, 2008)…

    • 290 Words
    • 2 Pages
    Satisfactory Essays
  • Good Essays

    We have all heard about Obama Care. What is Obama Care? Obama Care also known as the Affordable care Act is a nationwide health care plan that is aimed primarily to alter the American health. Obamacare primary focus is to regulate the health insurance industry create a reduction in the USA government spending on the healthcare. Does that mean all people of the United States be able to afford this health care insurance? The following paper will answer some of these important questions about Obama care and what the people of the United States can expect. Affordable Care Act is also known as the Affordable Care Act. The Affordable Care Act was undersigned into law on March 23, 2010. Many of us have been debating about health care reform for long time. Thousand or more pages of Obamacare…

    • 699 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Managed Care Case Study

    • 792 Words
    • 4 Pages

    For the past several years, the health care and insurance industries in America have been undergoing significant reform in order to rein in the high cost of delivering health care services. Managed care has become a cornerstone of this process (Strickland, 1995). The case management industry (with its focus on cost containment, managed competition, and quality care) is playing an increasingly important role in the managed care environment (Owens, 1996). According to Mullahy (1995a), the number of case managers has risen astronomically in recent years. These individuals come from diverse professional backgrounds and practice settings that include nursing, rehabilitation counseling, and social work.…

    • 792 Words
    • 4 Pages
    Good Essays
  • Good Essays

    Emergency Department overuse made the list because patient care has increased and not Decreased as expected when the Affordable Care Act (ACA) was passed. The Overuse continues and leads to needless expense, crowding and concerns that put patients at risk who need immediate care. Health Care Providers/Physicians are not able to keep up. Appointments are weeks to months out to see your Dr and what ends up happening is these patients go to the Emergency Department.…

    • 301 Words
    • 2 Pages
    Good Essays
  • Good Essays

    Managed care

    • 906 Words
    • 4 Pages

    Managed health care is a system of health care delivery managed by a company aiming mainly at quality/value cost effective services provided to patients. It has been introduced with an intention to avoid paying for unessential facilities and services directly to physicians. It helps in forming an intermediate between patients and physicians in such a way that health insurance organizations pay the physicians from the premiums paid by patients to insurers for the services provided. This helps in monitoring how cost effectively the services are utilized. It is not to be mistaken as health care delivery at discounted prices. It’s goal is to provide quality care at affordable prices by restricting patient’s choice of physicians and physicians limiting their fees. People who seek care in America are mostly enrolled in health care plans such as health maintenance organizations(HMOs) and preferred provider organizations(PPOs).The less common plan people are enrolled in is point-of-service(POS) which has features of both HMO and PPO.HMO provides integrated and preventive care services to voluntarily enrolled families with low premiums within the network of doctors and hospitals that belong to the organization. It requires to select a primary care physician(PCP) who serves as a personal doctor to provide all basic health care services. PCPs include family physicians and internal medicine physicians. Some HMOs consider pediatricians(for children), gynecologists(for women) as PCPs. Before seeing a specialist or for a diagnostic service, it is required to obtain a referral from PCP(“gatekeeper”). If an outside specialist is chosen or referral is not obtained before seeing a specialist, no coverage for services is rendered by HMO. All or most of the cost for the care must be taken care by the individual. In contrast to HMO, with a PPO it is not necessary to select a single doctor as policy holder’s PCP nor is it necessary to…

    • 906 Words
    • 4 Pages
    Good Essays
  • Better Essays

    Managed Care

    • 1382 Words
    • 6 Pages

    Permanente, Kaiser. (October 21, 2008) Kaiser Permanente Has Most Hospitals In Nation with Inpatient Electronic Health Record. Retrieved from < xnet.kp.org/newscenter/pressreleases/nat/2008/102108inpatientehr.html >…

    • 1382 Words
    • 6 Pages
    Better Essays
  • Better Essays

    Managed Care

    • 1408 Words
    • 6 Pages

    HealthPocket; analysis: 80 percent of health plans charge higher premiums than they first quote to consumers. (2013). Managed Care Business Week, , 5. Retrieved from http://search.proquest.com/docview/1313166853?accountid=32521…

    • 1408 Words
    • 6 Pages
    Better Essays
  • Good Essays

    The Affordable Care Act (ACA) has become the most controversial topic, and the most important health care problem facing the American people today. As a Health care Administrator the Affordable Care Act (ACA) affects the everyday job function. Nonetheless, the debates taking place in the future of the Affordable Care Act keep us paying attention to what is taking place. Health Administrator has to know all of the latest changes taking place. Strategies, job functions and health laws will all have to be changed provided there will be any changes coming to the ACA, or provided a brand new health law will be implemented.…

    • 1038 Words
    • 5 Pages
    Good Essays
  • Better Essays

    Managed Care

    • 3374 Words
    • 14 Pages

    There are so many problems with our society's health care. Everyone wants to find a…

    • 3374 Words
    • 14 Pages
    Better Essays
  • Powerful Essays

    The Philippine Health Insurance Corporation was created by Republic Act No. 7875 to administer the National Health Insurance Program which is designed to provide health insurance coverage and ensure affordable, acceptable and health services for all Filipinos.…

    • 2736 Words
    • 11 Pages
    Powerful Essays