Case Study 1

Mrs. Jones, who is 80 years old, presents to ABC Medical Associates today for her annual wellness visit. She was last seen 6 months ago by a doctor in the practice for a bout with influenza.

In today’s visit, the patient will receive her annual gynecological evaluation in addition to a general maintenance examination. She will also have blood work done to evaluate her hypertension, hypothyroid, and type II diabetes.

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Mrs. Jones is covered by Medicare and AARP Medigap insurance.

Based on the information in this case study, determine if this is a new or established patient. Then, describe what information you will need to collect from the patient and what steps you must take to ensure the services being rendered will be covered by insurance. Determine which insurance policy is primary.

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