Adjudication is defined as a legal process involved in settling disputes between two warring parties without resorting to extensive and costly court procedures. The term adjudication is used in the insurance industry to refer to the channel or process of paying or declining payment of claims after comparing the presented claims to the insurance coverage or benefits requirements (Vines-Allen et al 23). Therefore, any time an individual files a claim with an insurance company, what follows is the justification and payment process acknowledged as the insurance adjudication. According Vines-Allen et al (19), this process normally entails obtaining a claim from an insured ...
Insurance Company Critical Thinkings Samples For Students
4 samples of this type
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Abstract
The payer mix in healthcare financing currently comprises of three broad groups that include private insurance, government payers, and private payers. Private insurance covers 61% of the US population and contributes 49% in revenues. Government payers cover 31% of the population and contribute 55% of the revenues while the private payers account for 5% of population and contribute 6% of the revenues. The Affordable Care Act seeks to increase the insurance coverage in the United States. It would increase the contributions from government payer and reduce the default risk associated the private payers. This would also ensure that all ...
Part 1
It was on a Monday 3rd April 2016 when I was asked by my immediate manager at Unilever Company, to come up with a marketing plan. The plan would aim at increasing the production rate through online sales on the firm product lines. The development of the plan was to be done in collaboration with the company’s internet marketing department. I was given a period of two for the setting of the plan.
Shortly, after conversing with the web marketing team on the same, I realized the deadline would elapse before the work was accomplished and the deadline ...
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CRITICAL REVIEW OF ‘SICK AROUND AMERICA’
According to the article, “Sick around America” by the Frontline, the number of uninsured in the United States of America is increasing by the day. This saddening situation can be attributed to the deteriorating economic situation in the country. The country is currently under a declining economic state that is leading to a scenario of massive job losses through lay-offs and job-closures. The economy being the pillar supporting all economic activities in the country has in turn negatively affected the health system, particularly the Insurance sector. Frontline reports that the private insurance system fails to cover close to 46 million Americans, ...
