HIIM 322: Revenue Cycle Management

Week 2 Activities
Activity 1: Health Insurance Cards
Compare your healthcare insurance card to those of classmates.

1. List all the healthcare insurance companies represented by the cards of the members of the
group.
First Health, Problems, Blue cross blue sheal.
2. What information is included on all cards?
Name, ID, Group number, insurance name
3. What information varies amongst the cards in your group?
Effective date, Deductible copays.
4. Is the language on the healthcare insurance cards standardized?
No.
a. What differing terms seem to be used for the same thing?
None.
5. Go to the website of each healthcare insurance company. What are some hot topics?
 Diagnostic tests and imaging
 Immediate medical attention
 Outpatient surgery
 Preventive care
 Primary care visit to treat an injury or illness
 Maternity care
 Metal health, behavioral health, and substance abuse needs.
2021 Blue Cross Blue Shield Reviews: Health Insurance (consumersadvocate.org)
Commoditization
Improving quality of analytical data
Using data to improve experiences
What are some hot topics related to insurance on which research can be done? -
Quora
Activity 2: Cost Comparison Calculator
In the case that follows, apply the cost calculators available at the following website (under “How does
an HSA work?”): http://www.hsacenter.com/how-does-an-hsa-work/hsa-calculators/hsa-future-value-
calculator/

Alexander is 55 years old and lives in Boise, ID. He is currently on a PPO plan. He pays $99/month for
premiums. He has a $700 deductible for in-network providers. This year, Alexander saw his in-network primary
care provider (a family practice physician). He paid a $20 copay. His primary care provider ordered a
colonoscopy. Alexander had the colonoscopy at an in-network ambulatory surgery center. No abnormalities
were found. After meeting his deductible, his coinsurance to the facility was $664, to the physician was $400,
and to the anesthesiologist was $100. Alexander has a chronic skin condition. Each year, he sees his
dermatologist in order to have his prescription renewed. He pays $85 for this office visit. The prescription for
his daily medication is a common antibiotic for which his physician orders the generic equivalent. He pays a
$10 monthly copay for this prescription. He is a former high-school and college quarterback. He currently
 exercises 60 to 90 minutes per day, alternating daily between cardiovascular and free-weight routines. Last
year, his hip started to “catch” sporadically. He saw a physical therapist twice. Each visit cost Alexander $52.
The physical therapist gave him two sets of exercises to strengthen the muscles supporting the hip joint.
Alexander is tired of paying premiums, and wonders if a high deductible HSA plan would be better.

 How much did Alexander spend on his health expenses (insurance premiums + cost sharing) this
year? $1,188 + $2,193 = $3,381
 Try the HSA Future Value Calculator. If he is putting in $3,000/year into an HSA with a $1,300
deductible and the above description is indicative of his average year in expenses, what is the
future value of his HSA? (Assume he meets his deductible and cost sharing is the same)
The future values of HAS is $2671.27
o What are his tax savings on contributions and earnings?
His tax saving on contributions and earnings is $2580
o What if he decided to only put in the $1,200, he’s paying in premiums now (but his
medical expenses stayed the same)?
If he decided to only put in the $ 12,00, in three year he will losing a lot of money. He
will still in negative each year.
 In your opinion, should Alexander change his health insurance from the PPO plan to a high-
deductible plan with a health savings account? Why or why not?
In my opinion, I think Alexander should stay with his health insurance PPO because he doesn’t
pay off, he is consistently having more medical expenses, then he is able to cover with HAS so he
is still basically paying all $5761.30 out of pocked in five years. And of course, because of his age,
and it will be higher risk for him to switch, he can’t predict his medical cost every year.

Activity 3: Health Insurance Policies

Compare and contrast at least four health insurance policies from at least two health insurance
companies. Include premiums (if known), deductibles, and out-of-pocket costs (co-pays and co-
insurance) and coverage for drugs, office visits, inpatient care, outpatient/ambulatory surgery,
emergency services, mental health, outpatient therapy, alternative and complementary medicine
(chiropractic, acupuncture, etc.), dental, vision, emergency transport (ambulance) services, home care,
and skilled nursing facility care. Include provisions, such as pre-authorization requirements and wellness
qualifications.

Create a table to highlight the similarities and differences. What insurance would be the best choice for
you? Why?