Imma2015 Assignment 1

Birth to Three program has a certain requirement that the child needs to meet for him/her to be deemed eligible, those requirements

Provider was calling because the newborn charges were denying because it had been paid under the mother’s claim. The provider stated

If the prenatal don't complete her payments for the prenatal care visits receive. We need to bill the patient the final

The main benefit associated with this policy is that health insurance companies will typically pay for delivery and care carried out by a nurse midwife in the hospital that is compliant with these laws. Large companies, such as Blue Cross and Blue Shield of Alabama, will not pay for any midwife outside of the hospital, even if she had a permit by the state. The other benefit is that in the event that some emergency was to occur before, during, or after delivery, a trained physician and advanced technology are readily available to take over.

Regardless of healthcare and medical advances, birth outcome disparities continue to exist in the United States. In 2014, 1 out of 10 infant births were premature, correlating to over 380,000 infants born prematurely (Health 2016). The current national average for infant births before 37 weeks is 9.6% (Services 2010). Premature birth is identified as a birth that occurs before the 37- week gestation. During the preterm period, infants are placed at a high risk of death and developing disabilities that may cause permanent handicap. Mothers that give birth preterm may partake in risky behaviors such as smoking and drug usage, lack proper nutrition, and are burdened financially. Maternal education intervention programs centered around the Health Belief Model may have a positive impact on maternal care and prevent premature birth.

Normal open enrollment for health insurance coverage ends February first of every year, but allows a late entrance penalty for voluntary health benefits such as dental. The penalty, including a 12-month and 24-month waiting period for certain benefits, is in place to avoid the existence of adverse selection since employees would only enroll in the plan when they needed healthcare goods and services, if not waiting period existed for late

Insured Members are receiving credit for their prior coverage with the prior iCHIP carrier. There are three possibilities (see below) to determine if the pre-existing, maternity, or the wellness waiting periods are applicable.

Gloria Benson has been working for the Jackson State Health Department (JSHD) for about 15 years and has been the Prenatal Presumptive Eligibility (Prenatal PE) manager for about 9 years. Recently the JSHD received additional grant money to expand on the Prenatal PE program by offering new benefits to the people of Jackson. The contract originally outlined that, Presumptive Eligibility gives pregnant women of Jackson, JackCare coverage for sixty-two (62) days to allow time to apply for regular Medicaid through the federally marketplace located on the healthcare.gov website. If no Medicaid application is filed during the Presumptive span of eligibility, then coverage could end. With the expansion the contract outlines that, applications for

If we are unable to verify that the newborn has active coverage within 30 days of the newborn inpatient encounter, the encounter is then changed to self-pay.

Please provide updated information regarding the aforementioned document. As you are aware, I have made attempts to obtain updated medical document for the child since the document submitted is outdated - February 2014. Justin's mother informed me that the child was seen by the Primary Care Physician at your facility sometime in March 2015.

I review prenatal account and discuss with DTW and the patient complete her prenatal payment since she start with BCBS on 12.1.2016 to 12.30.2016 and Aetna start effective on 01/01/2017.The billing department from DTW told me that they receive payments already for her visits. On this case would you please adjust her balance since we receive 2 payments for the two visits that she wasn't coverage.

Medicaid and Commercial insurance plans require that newborns be enrolled in insurance within 30-31 days from a date of birth. Currently, the nonmember policy states that for non-member Medicaid newborns there is the option of being treated at KP for the first 60 days of life. I would make a guess that the same policy would apply for uninsured and commercial insured non-members.

This coverage is limited to the amounts defined in the maternity coverage rider. Make sure that you take time to completely understand the maternity rider offered by an insurance company before you make the decision to buy the insurance coverage. If you have insurance through your job, typically known as group insurance, then the coverage is usually more comprehensive.

All infants who are premature or at high risk need to be treated at birth at the NICU by specialists. [3]

Yes, That is the same prenatal patient. I just have one more request about this account. Could you please add some note on V#10922800 saying that the patient BCBS was only active for January 2015 .On that way if the patient call later to ask about her bill we can let the patient know the reason why she is responsable for the balance.