Question

"PATIENT IS BROUGHT TO THE LOCAL URGENT CARE AFTER FALLING FROM A LADDER WHILE HANGING EXTERIOR LIGHTS ON HIS HOUSE. X-RAYS REVEALED A CLOSED FRACTURE OF HIS LEFT FEMUR. THE PATIENT IS COVERED BY HIS EMPLOYER'S GROUP HEALTH PLAN AND HE ALSO HAS A HOMEOWNER'S LIABILITY INSURANCE POLICY. WHICH INSURANCE SHOULD BE BILLED?

A) THE HOMEOWNER'S INSURANCE FIRST, FOLLOWED BY THE GROUP HEALTH PLAN
B) THE EMPLOYER'S GROUP HEALTH PLAN
C) THE HOMEOWNER'S INSURANCE ONLY
D) FILE THE EMPLOYER'S GROUP HEALTH PLAN AS PRIMARY AND LIST THE HOMEOWNER'S INSURANCE AS SECONDARY."

Answer 1

For a fall resulting in a closed fracture of the left femur, the employer's group health plan should be billed first for the medical costs. The homeowner's insurance may be involved if property liability is an issue.

Step-by-step explanation:

The question regards which insurance should be billed when a patient is brought to urgent care after falling from a ladder and incurring a closed fracture of the left femur, given that the patient has coverage from an employer's group health plan and a homeowner's liability insurance policy. In the context of the United States, typically the patient's group health plan would be billed for the healthcare services provided, as this is considered a personal medical issue and not one necessarily related to homeowner's liability.

However if the injury can be attributed to a fault or negligence related to the property then the homeowner's insurance might also be involved. The best course of action, therefore would be to bill the employer's group health plan first and then determine if homeowner's insurance applies based on the liability conditions of the incident.