patient case report insurance example

Patient Advocate Case Examples Case: 64 year old man was turning 65 and needed Medicare insurance advice Patient Advocate: Got a medical history and coordinated his records Contacted several insurance companies about supplemental Medicare insurance plans

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What is a medical case report?

What is a case report? A medical case report, also known as a case study, is a detailed description of a clinical encounter with a patient.

What are the five sections of a patient case report?

Summary: The format of a patient case report encompasses the following five sections: an abstract, an introduction and objective that contain a literature review, a description of the case report, a discussion that includes a detailed explanation of the literature review, a summary of the case, and a conclusion.

How do you write an abstract for a patient case report?

Summary: The abstract of a patient case report should succinctly include the four sections of the main text of the report. The introduction section should provide the subject, purpose, and merit of the case report.

How do you write a description of a patient case?

The description of the patient case is one of the most integral sections of the case report. It should describe the case in chronological order and in enough detail for the reader to establish his or her own conclusions about the case’s validity.

What is a case study in insurance?

Written By: Society Insurance Team. Society's insurance case studies are real-life stories, explaining complex business situations from start to finish. These stories detail how business owners and insurance companies work together to overcome unique and unexpected challenges.

What is a summary of coverage?

An easy-to-read summary that lets you make apples-to-apples comparisons of costs and coverage between health plans. You can compare options based on price, benefits, and other features that may be important to you.

What is case in medical billing?

Case Rate — a flat fee paid for healthcare services based on client characteristics (such as diagnosis). When a case rate is used, the healthcare provider covers all of the services the client requires for a specific time period. Also known as a bundled rate or flat fee-per-case.

What is a patient claim?

What is a Claim? Simply put, a claim is what a doctor submits to your insurance company so they can get paid. It shows the medical services that were provided to you. Submitting a Claim Yourself. Typically, your doctor or provider, especially if they're in your plan, will submit the claim for you.

What is included in a summary of benefits and coverage?

The SBC is a snapshot of a health plan's costs, benefits, covered health care services, and other features that are important to consumers. SBCs also explain health plans' unique features like cost sharing rules and include significant limits and exceptions to coverage in easy-to- understand terms.

How do I get a summary of benefits and coverage?

Where can I find a Summary of Benefits and Coverage? You'll find a link to the SBC on each plan page when you preview plans and prices before logging in, and when you've finished your application and are comparing plans. You can ask for a copy from your insurance company or group health plan any time.

What are the 4 types of case management?

There are four key components within this definition that make up successful case management: Intake, Needs Assessment, Service Planning, and Monitoring and Evaluation. Human service organizations of all sizes require the correct implementation of these four components to ensure client success.

What is case management in health insurance?

The definition of case management is the planning, processing, and monitoring of the healthcare services given to a patient by a coordinated group of healthcare providers.

What is patient case management?

Case management is defined as a health care process in which a professional helps a patient or client develop a plan that coordinates and integrates the support services that the patient/client needs to optimize the healthcare and psychosocial possible goals and outcomes.[1] The case management process helps the ...

What are the 3 most important aspects to a medical claim?

Three important aspects of medical billing are claims validation, the migration of crucial software from local servers to cloud computing service providers and staying current on codes.Claims Validation. ... Cloud Computing. ... Codes and Compliance.

How do you process an insurance claim?

Your insurance claim, step-by-stepConnect with your broker. Your broker is your primary contact when it comes to your insurance policy – they should understand your situation and how to proceed. ... Claim investigation begins. ... Your policy is reviewed. ... Damage evaluation is conducted. ... Payment is arranged.

What is a frequent reason for an insurance claim to be rejected?

Many claim denials start at the front desk. Manual errors and patient data oversights such as missing or incorrect patient subscriber number, missing date of birth and insurance ineligibility can cause a claim to be denied.

What is a patient care report?

A patient care report is a document made mostly by the EMS or EMTs. This documented report is done after getting the call. This consists of the inf...

What should not be written in a patient care report?

What should be avoided in a patient care report is making up the information that is not true to the patient. This is why you have to be very caref...

Who is in charge of reading the patient care report?

The person or the people who will be reading the report are mostly medical authorities. When you are going to be passing this kind of report, make...

What is a patient case study?

Writing Your Patient Case Study. Since patient case studies are generally descriptive, they are under the a phenomenological principle. This means that subjectivity is entertained and allowed in research design. The medical scenarios are open to the researcher’s interpretation and input of insights.

Why do medical practitioners use case studies?

Medical practitioners use case studies to examine a medical condition in the context of a research question. They perform research and analyses that adhere to the scientific method of investigation and abide by ethical research protocols. The following are case study samples and guides on case presentation.

What is a case study?

Case studies are a qualitative research method that offers a complete and in-depth look into some of the situations that baffled medical science. They document the cases that escape the ordinary in a hospital that has seen a manifold of plights. They serve as cautionary tales of the intricacy in dealing with human health.

How do case studies make a difference in the medical arena?

Patient case studies make a difference in the medical arena by reporting clinical interactions that can improve medical practices, suggest new health projects, as well as provide a new research direction. By looking at an event as it exists in the natural setting, case studies shed understanding on a complex medical phenomenon.

Can you generalize a population using one case study?

You cannot generalize a population using one case study. However, multiple case study contains two or more cases under the point of interest can give you a replicated result. When the findings remain true for several cases under this research method, your case study’s results become more reliable.

Should you look into all possible explanations for a medical condition?

You should look into all of the possible explanations for the medical condition at hand. If a plight can be explained by more than one reason , then you have to look into the less obvious but similarly compelling explanations. Make your case study as informative as possible.

Is a clinical interaction report valid for generalization?

Since it documents stand-out clinical interactions where a single person or a few number of people are a party of, the findings may not be valid for generalization for a wider population.

Case: 70 year old metastatic melanoma patient was looking for experts on Hyperbaric Oxygen Therapy

Patient has been a client of Patient Advocate for many years so their medical records were organized in MyMedicalRecords.com electronic records management system.

Case: 64 year old male complained of flank pain

Got him to a Urologist for evaluation Coordinated his x rays and lab work. Escorted him to the hospital when surgery was necessary Created a pre-op and post op care plan. Monitored him at home post op.

Case: 48 year old male, diagnosed 2 years ago with Hepatitis C

He had been waiting for the newest treatment regime. The doctor has given him the prescription with all the potential side-effects, and now the patient is concerned about starting treatment. His question was: “How do I know if I will be the one to have all these side-effects?”

CASE: 42 year old female was diagnosed after having biopsy with breast cancer

She was referred to us by her friend, a physician. Never having been in a Hospital before she had no idea of what to expect.

CASE : 48 year old female patient had a routine annual mammogram and no follow up

3 weeks later she received a letter from the clinic where the x-rays were done asking her why she had not returned for more test. She asked why she needed more “tests” and they gave her a vague answer. She schedule another visit to have “more tests”.

CASE: The son of a 79 year old man contacted us about obtaining some wound care for his father

His father had just had Melanoma surgery on his back, and was told by his doctor that he could make the 4 hour drive to visit his son and his new grand daughter for a few days if they could arrange for dressing changes, and post op wound monitoring

What is a case report?

Case Report: A Beginner’s Guide with Examples. A case report is a descriptive study that documents an unusual clinical phenomenon in a single patient. It describes in details the patient’s history, signs, symptoms, test results, diagnosis, prognosis and treatment.

Why do we need case reports?

Case reports offer, in general a fast, easy and cheap way to report an unusual observation or a rare event in a clinical setting, as these have very small probability of being detected in an experimental study because of limitations on the number of patients that can be included.

Is a case report causal?

Observing a relationship between an exposure and a disease in a case report does not mean that it is causal in nature. The absence of a control group that provides a benchmark or a point of reference against which we compare our results. A control group is important to eliminate the role of external factors which can interfere with ...

Is a case report representative of the entire population?

So, results from a case report cannot be representative of the entire population.

Simple Medical History

Once you have collected these medical data, you can record them as a pdf by using this medical history PDF template. In addition, you don't need to be worried about the safety of data, because our forms are HIPAA compliant.

Doctors Note

Validate the medical condition of the patient by giving them a Doctor's Note Template. This PDF template shows the medical diagnosis of the patient and medical treatment.

Patient Medical Record

Medical History Record PDF template lets you collect the patient's data such as personal information, contact information in an emergency case, general medical history. By using this sample, the doctor ensures the patient's better care and treatment.

Short Medical History

Medical History Record PDF template is mostly used in order to provide significant information about the health history, care requirements, and risk factors of the patient to doctors. It is for collecting data from the patients.

Veterinary Hospital Treatment Sheet

Veterinary Hospital Treatment Sheet helps both the hospital and pet owners in understanding and tracking a pet's treatment process. Just like any other hospitals, keeping patient's treatment records is necessary to monitor progress and make sure proper treatment is given.

COVID-19 Vaccine Administration Record

Keep track of patient vaccination records online. Secure with GDPR, CCPA, and optional HIPAA compliance. Download or print as PDFs. Free, easy-to-customize template.

Dental Health Record

The Dental Health Record Template is easy for patients to fill out and designed to get the doctor the most important information. Patients can fill out their information on a computer or tablet using our Dental Health Record Template.

What is required to submit a case report?

Journals often have specific requirements for publishing case reports, which could include a requirement for informed consent, a letter or statement from the IRB and other things.

What should I do after writing a case report?

Once you have written a draft of the case report, you should seek feedback on your writing, from experts in the field if possible, or from those who have written case reports before .

Why is it important to write a case report?

the reason you would go to the trouble of writing one, is that the case is sufficiently unique, rare or interesting such that other medical professionals will learn something from it.

Does CHM have funding for publication?

It is best practice to check the journal's Info for Authors section or Author Center to determine what the cost is to publish. CHM does NOT have funds to support publication costs, so this is an important step if you do not want to pay out of pocket for publishing.

Is it free to publish a case report?

Be aware that it may not be free to publish your case report. Many journals charge publication fees. Of note, many open access journals charge author fees of thousands of dollars. Other journals have smaller page charges (i.e. $60 per page), and still others will publish for free, with an "open access option".

Do you need informed consent for a case report?

Although not technically required, especially if the case report does not include any identifying information, some journals require informed consent for all case reports. The CARE guidelines recommend obtaining informed consent AND the patient's perspective on the treatment/outcome (if possible).

Does HIPAA apply to case reports?

First, you will be collecting protected health information, thus HIPAA applies to case reports. Spectrum Health has created a very helpful guidance document for case reports, which you can see here: Case Report Guidance - Spectrum Health. While this guidance document was created by Spectrum Health, the rules and regulations outlined could apply ...

Abstract

Format of The Patient Case Report

Summary

Conclusion

Appendix A—Criteria For Publishable Case Reports

• Publishable patient case reports include cases that: 1. Advance medical science and spawn research; 2. Describe rare, perplexing, or novel diagnostic features of a disease state; 3. Report therapeutic challenges, controversies, or dilemmas; 4. Describe a new surgical procedure; 5. Report how a drug can enhance a surgical procedure; 6. Teach humanis...

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