by Systemedic | Mar 4, 2017 | Case Studies
Situation A 36 year old woman required extensive services from her obstetrician during her high-risk pregnancy. These services involved a number of ultrasounds throughout her pregnancy to monitor the growth of the fetus. After a healthy baby was born, the woman began...
by Systemedic | Feb 18, 2017 | Case Studies
SITUATION A 32 year old woman was pregnant. She had insurance coverage through her husband’s employer. She received all of her prenatal care through in-network doctors and facilities. All of the prenatal claims were submitted to her husband’s insurance and paid by...
by Systemedic | Feb 4, 2017 | Case Studies
SITUATION A 25 year-old female with persistent nasal congestion, sinus pressure, and sore throat that had not responded to numerous treatments prescribed by her primary care doctor PATIENT PROCESS In a phone call to her doctor, the patient was instructed to return to...
by Systemedic | Jan 21, 2017 | Case Studies
Situation A 23 year old woman suffered from a variety of symptoms, including extreme fatigue, dizziness, and joint pain, symptoms that increased in type and frequency and grew to include headaches, memory loss, difficulties concentrating, hair loss, facial and...
by Systemedic | Dec 17, 2016 | Case Studies
Situation A 30 year-old male wanted to schedule a yearly physical/well visit with his primary care doctor. He assumed that this visit and all procedures associated with it should be fully covered and paid by his insurance company without any out-of-pocket cost to...
by Systemedic | Dec 3, 2016 | Case Studies
CASE STUDY: DENIED INFUSION TREATMENT Situation A 47 year old man suffering from rheumatoid arthritis for more than 15 years, was denied authorization by his new insurance company for an infusion therapy that had been authorized by a previous insurer, and from which...
