Review of Health Care Insurance Plans and Payment Methods

You are a new graduate, and you just started work at a medium-sized hospital with an attached clinic. You have been asked to review the five different types of health care insurance plans and the characteristics of each to make sure the central business office (CBO) is up-to-date on all the rules and regulations. It is important to be familiar with these plans and the characteristics of each because they play a vital role in the reimbursement process for your health care organization. Discuss the following:
• List the five different types of health care plans and 2–3 characteristics of each.
Each of the five insurance plans (Medicare, Medicaid, TRICARE, Worker’s Compensation, and Commercial Insurance are governed by either federal, state, or local agencies, or they are administered by private organizations and business.
• Explain why it is important to understand the differences in these plans.
• What are some of the similarities between the plans?
• What are some of the differences?
• Would an out-of-date policy from one of these plans affect the facilities reimbursement? If so, how?