First Indemnity Model

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| Origin: When was the model first used? | What kind of payment system is used, such as prospective, retrospective, or concurrent? | Who pays for care? | What is the access structure, such as gatekeeper, open-access, and so forth? | How does the model affect patients? Include pros and cons. | How does the model affect providers? Include pros and cons. | Indemnity | The early origins of first indemnity date back to 1958 when Biggio Insurance Agency was founded by John M. Biggio. First indemnity emerged just over two decades later by John’s son, Andrew Biggio, in Lynn, MA. ( During the 1990’s, First indemnity developed strong business relationships with P&C agencies and brokerages. By the early 2000’s, Andrews business…show more content…
Founded in 1980, Multiplan has over half a million health care providers under contract. Preferred Provider Organization (PPO) came about due to the fact that indemnity insurance plans did not cover simple things like, routine check-ups, and doctor office visits. HMO patients requiring a specialists or major medical procedures must be referred by a primary care physician, and authorized by the insurance company in advance of the procedure. ( Since this was problematic for both the patients and doctors, the PPO was established. PPOs first started appearing as competitors to HMOs in the late 1970s to provide consumers with more options. | A PPO plan is a U.S health care organization that negotiates set rates of reimbursement with participating health care providers for services to insured clients. This is a type of prospective payment system, and provides the policyholder with an incentive to receive care from this group. Medical services provided outside this group are also covered. (www.thefree | The policyholder pays a premium each month and, in exchange, the insurance company pays the cost of medical care, after a deductible and co-insurance. Insured members pay a co-payment at the time of an office visit to a physician. After the co-payment the insurance company will pay a percentage, usually the remainder of…show more content…
HSA are meant to replace high cost, low deductable health insurance policies. Also used to supplement retirement if you are healthy because the money can stay in the account and grow with tax advantage. ( A health savings account is similar to an IRA account, devoted solely to health expenses and used with high deductibles health insurance policy. | Type of payment system is concurrent because payment is due at time of service. There is also an option of a prospective payment system because physicians receive a fixed payment rate to specific treatments; this amount is consistent for the same type of treatment. The network the insurer chooses determines the payment system. | You not your employer or insurance company own and control the money in your health savings account. The idea of HSA is that people will spend their health care dollars more wisely if they’re using their own money. ( An employer may make contribution to the account but they do not pay for the services provided to you by doctors. | Access structure depends on the underlying health plan. ( Having a HSA plan allow the insurer to see any doctor or specialist without a referral, and since accounts are like a credit card, you can choose the plan you want. They are mostly open-access plans because you have the

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