Unit 2 Assignment – Coordination of Benefits
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- Due Sunday by 11:59pm
- Points 80
- Submitting a text entry box or a file upload
Instructions
Estimated Time to Complete: 3 hours
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Utilize the knowledge gained through the readings and discussion throughout Unit 2 to coordinate the benefits for a patient.
Instructions: Sarah went to the emergency room in January with pain in her stomach. She was sent home within 24 hours. In March, she had an appendectomy. Sarah has Medicare A.
- Review the document, Managed Care Organization Comparison.
- Select another managed care organization from the table to serve as Sarah’s secondary insurance.
- Coordinate the benefits for her emergency room visit and procedure between Medicare A (which must serve as the primary insurance plan) and the secondary insurance plan. Include the following information:
- Rationale for the plan selected as Sarah’s secondary insurance. Include any special considerations that contributed to the selection
- Summary of relevant benefits covered under each plan
- Limitations: care needed but not covered by either plan (if applicable)
- Complete additional research as necessary on the two types of insurance plans. Be sure to cite any resources.
Rubric
Coordination of Benefits
Coordination of Benefits
| Criteria |
Ratings |
Pts |
|
This criterion is linked to a Learning OutcomeSecondary insurance and rationale
|
| 0.0 pts
Non Performing
Student did not submit the assignment
|
1.0 pts
Non-proficient (1)
Student selects an secondary insurance plan that is inappropriate and provides little rationale for selection.
|
4.0 pts
Low Level Proficiency (2)
Elements of both Moderate Proficiency and Non-proficient are present
|
7.0 pts
Moderate Proficiency (3)
Student selects an secondary insurance plan that is acceptable and provides some rationale for selection.
|
8.0 pts
Moderately High Proficiency (4)
Elements of both High Proficiency and Moderate Proficiency are present
|
10.0 pts
High Proficiency (5)
Student selects an appropriate secondary insurance plan and provides rationale for selection.
|
|
10.0 pts
|
|
This criterion is linked to a Learning OutcomeCoordination of benefits
|
| 0.0 pts
Non Performing
Student did not submit the assignment
|
10.0 pts
Non-proficient (1)
Coordination of benefits for emergency room visit and procedure between Medicare A and secondary plan is not accurate and/or appropriate.
|
19.0 pts
Low Level Proficiency (2)
Elements of both Moderate Proficiency and Non-proficient are present
|
28.0 pts
Moderate Proficiency (3)
Coordination of benefits for emergency room visit and procedure between Medicare A and secondary plan is mostly accurate and appropriate.
|
34.0 pts
Moderately High Proficiency (4)
Elements of both High Proficiency and Moderate Proficiency are present
|
40.0 pts
High Proficiency (5)
Coordination of benefits for emergency room visit and procedure between Medicare A and secondary plan is accurate and appropriate.
|
|
40.0 pts
|
|
This criterion is linked to a Learning OutcomeBenefit description
|
| 0.0 pts
Non Performing
Student did not submit the assignment
|
6.0 pts
Non-proficient (1)
Benefits for each plan are not accurate and/or not described concisely, limitations of plans are not described and selection of (and reasoning for) primary plan is not sound.
|
12.0 pts
Low Level Proficiency (2)
Elements of both Moderate Proficiency and Non-proficient are present
|
18.0 pts
Moderate Proficiency (3)
Benefits for each plan are mostly accurate and described somewhat concisely, limitations of plans are somewhat described and selection of (and reasoning for) primary plan is mostly sound.
|
22.0 pts
Moderately High Proficiency (4)
Elements of both High Proficiency and Moderate Proficiency are present
|
25.0 pts
High Proficiency (5)
Benefits for each plan are accurate and described concisely, limitations of plans are described and selection of (and reasoning for) primary plan is sound.
|
|
25.0 pts
|
|
This criterion is linked to a Learning OutcomeTechnical Requirements
|
| 0.0 pts
Non Performing
Student did not submit the assignment
|
1.0 pts
Non-proficient (1)
Spelling and grammar are not accurate (3+ errors), standard American English and professional writing style used (3+ errors). References provided with 3+ errors in formatting.
|
2.0 pts
Low Level Proficiency (2)
Elements of both Moderate Proficiency and Non-proficient are present
|
3.0 pts
Moderate Proficiency (3)
Spelling and grammar are mostly accurate (1-2 errors), standard American English and professional writing style used (1-2 errors). References provided with 1-2 errors in formatting.
|
4.0 pts
Moderately High Proficiency (4)
Elements of both High Proficiency and Moderate Proficiency are present
|
5.0 pts
High Proficiency (5)
Spelling and grammar are accurate, standard American English and professional writing style used. References are provided using APA format.
|
|
5.0 pts
|
|
Total Points: 80.0
|
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