Question

Which refers to the contractual right of a third-party payer to recover health care expenses from a liable party?

1) claims adjudication
2) appeal
3) subrogation
4) arbitration

Answer 1

The term for the contractual right of a third-party payer to recover health care expenses from a liable party is subrogation, which is in line with property and contractual rights that allow for legal recourse to uphold financial responsibilities.

Step-by-step explanation:

The contractual right of a third-party payer to recover health care expenses from a liable party is referred to as subrogation. This concept allows an insurer to take on the legal right to seek reimbursement from a party that is liable for an insured loss. For instance, if an insurance company pays for medical expenses resulting from an accident, and it is later determined that another party was at fault for the accident, the insurer can pursue recovery of those funds through subrogation.

In the context of health care insurance, this process helps insurers manage costs and can prevent the shifting of expenses to the insured parties when another party is responsible. It also upholds the principles of contractual and property rights by ensuring the parties adhere to their legal and financial responsibilities.