Question

When primary payment is received, the actual reimbursement

a) Increases the patient's liability
b) Triggers a refund to the payer
c) Closes the account balance
d) Requires legal intervention

Answer 1

The receipt of primary payment in a health insurance context usually means a refund is issued for overpayment or the account balance is closed once payment covers service costs; it does not increase patient liability or routinely require legal intervention.

Step-by-step explanation:

When primary payment is received in a health insurance context, it typically triggers a refund to the payer if there has been an overpayment, or it may closes the account balance if the payment matches the cost of services rendered. Option (a), increasing the patient's liability, does not generally occur as primary payment aims to reduce or settle the liability. Option (d), requiring legal intervention, is not a standard procedural step upon receiving a primary payment but might occur in exceptional cases where there is a dispute.