Final answer:
The statement is false; it's not only the patient's responsibility to contact insurers about payment disputes. Both healthcare providers and patients may be involved. Insurance companies negotiate lower rates due to large client numbers, benefiting both the company and insured individuals.
Step-by-step explanation:
The statement in question is false. While the assistant may advocate for the patient in terms of treatment and care, it is not solely the patient's responsibility to contact the insurer in the case of a denial of payment for non-covered services. Both the health care providers and the patients have roles in addressing disputes with insurance companies.
In a fee-for-service health financing system, providers are reimbursed based on the cost of the services they render. However, in health maintenance organizations (HMOs), reimbursement is based on patient numbers rather than specific services, placing the onus on the providers to manage resources effectively. With insurance, the concept of adverse selection can lead to a skewed risk pool, and the insurance company must navigate these challenges.
Moreover, due to the large number of clients they manage, insurance companies have the ability to negotiate for lower rates with service providers, a benefit not usually available to individuals. This allows for cost savings for both the consumers and the insurance companies when claims are paid.