Types of Consent and Payers
The purpose of this assignment is to help you understand the types of patient consent and what role they play in the health care industry. It is important also to understand the legal issues and laws that regulate third-party payers.
http://myresource.phoenix.edu/secure/resource/HCS430r8/hcs430_v8_wk3_consent_payers_chart.docx
Complete the Types of Consent and Payers Chart. Must use chart 🙂
Make sure you carefully adhere to the word requirements of the assignment.
Cite 2 peer-reviewed, scholarly, or similar references to support your paper.
ANSWER
Types of Consent and Payers
Part 1
Complete the chart and questions below.
| Type of consent | Define the type of consent (20 to 45 words) | Identify 4 principles of consent (20 to 45 words) | Describe the impact of consent on the health care industry (45 to 90 words). |
| Informed consent
|
This involves communication between a person and their healthcare provider, which leads to agreement or permission for care treatment or service. | 1.     Disclosure of information
2.     Patient competence to make a decision 3.     Voluntary nature of the decision 4.     Documentation of consent |
Informed consent in the healthcare industry helps one to participate in their care. It gives one the power to decide the kind of treatment they want to receive and thus influences patient-centered care. |
| Implied consent
|
Implied consent is not expressly given like informed consent. Implied consent involves the person’s actions and the facts and circumstances. | 1.     Implied consent occurs through actions.
2.     It is time-limited 3.     It is hard to prove 4.     It is implied through actions such as showing up for surgery or nodding the head.
|
Implied consent is relied upon by healthcare professionals in the case where there is an absence of consent. For example, if a patient says nothing but shows up for surgery, the doctor will go ahead and do the surgery. It helps healthcare providers provide care. It is, however, not a replacement for explicit rejection of medical care. |
Answer each of the following questions using 90 to 175 words.
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- Describe four exceptions (federal or state level) to consent.
If the patient is incapacitated, when the patient is incapacitated and cannot provide consent, the healthcare practitioners can offer the treatment without consent (Shah et al., 2021).
In life-threatening situations where there is no time to obtain consent from the next of kin, the doctors will offer treatment. For example, if they are in surgery and the patient requires something, they offer the treatment without asking the family or the patient to prevent the patient from dying.
In situations where the patient waives their consent and allows the doctor to offer treatments. In this case, the consent is exempted.
If the patient does not have the ability to make decisions or if their ability is questioned, they are exempted from consent.
- What impact do exceptions to consent have on the health care industry?
Exceptions on consent help the healthcare providers to help patients in situations where the patient is incapacitated. If there were no exceptions to consent, patients would die before they get treatment (Shah et al., 2021).
- Describe two exceptions to consent within your state.
In Florida, minors may receive maternal health and contraceptive information and services of nonsurgical nature without parental consent. However, this can only happen if they are married, have become parents, are pregnant, or if the doctor feels that failure to prove the services would be a health hazard.
Minors can also receive treatment for sexually transmitted diseases without parental consent.
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Part 2
Complete the chart below.
| Identify three third-party payers. | Describe the third-party payer (20 to 45 words). | Describe the legal issues that regulate the third-party payer (45 to 90 words). | Describe an applicable law that regulates the third-party payer (45 to 90 words). | Describe the impact that the legal issue and applicable laws have on the third-party payers (45 to 90 words). |
| 1. Medicare | This is a government-funded healthcare insurance program (Center for Medicaid and Medicare). | Privacy and data security, telehealth, provider alignment, fraud, and abuse. | The third-party regulatory law regulates this third-party payer. This law protects the insurance consumers and the policy holders. They are involved in standardizing policies | The impact of the laws is that it keeps the insurers protected as well as the consumers. It ensures that insurers and the consumers are working together and being fairly compensated. |
| 2. insurance companies private/public | These are companies that allow people to purchase healthcare plans from them. | Privacy and data security, telehealth, provider alignment, fraud and abuse | The third-party regulatory law regulates this third-party payer. This law protects the insurance consumers and the policy holders. They are involved in standardizing policies. | The impact of the laws is that it keeps the insurers protected as well as the consumers. It ensures that insurers and the consumers are working together and being fairly compensated. |
| 3. health maintenance organizations | Health maintenance organizations combine healthcare providers with insurance companies to reduce the cost of healthcare. | Privacy and data security, telehealth, provider alignment, fraud and abuse | The third-party regulatory law regulates this third-party payer. This law protects the insurance consumers and the policy holders. They are involved in standardizing policies. | The impact of the laws is that it keeps the insurers protected as well as the consumers. It ensures that insurers and the consumers are working together and being fairly compensated. |
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References
Centers for Medicare & Medicaid Services (CMS), HHS. (2018). Medicare Program; Contract Year 2019 Policy and Technical Changes to the Medicare Advantage, Medicare Cost Plan, Medicare Fee-for-Service, the Medicare Prescription Drug Benefit Programs, and the PACE Program. Final rule. Federal register, 83(73), 16440-16757.
Shah, P., Thornton, I., Turrin, D., & Hipskind, J. E. (2021). Informed Consent
