The case is about Gerald who had a health insurance cover that had an 80/20 copayment arrangement. When Gerald received a surgery bill of $950, he wanted to ascertain that the insurance company actually paid $760 or 80% of the total bill. A copayment plan requires patients to pay a portion of their medical bill in accordance with a pre-agreed ratio (Chang, 2014). Upon investigation, Gerald discovered that the insurance company had negotiated for a discount and their part of the bill was only $374. However, Gerald Copayment of 20% was still based on the original fee and not ...
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