Premium Essay

Medical Mutual Case

Submitted By
Words 826
Pages 4
Medical Mutual is the oldest health insurance company in the state of Ohio, starting in 1934. It covers over 1.5 million residents with over 43,000 primary care and specialist providers in the network. Medical Mutual is a not-for-profit company, which means it uses its revenues to further the company instead of paying its shareholders. I believe that is why this company has continued to grow instead of being bought out, since they are putting all their money back into helping advancement instead of paying off the people who are invested. Medical Mutual is also one of the biggest employers in downtown Cleveland (HQ location).
In 2011 Medical Mutual made InformationWeek 500’s annual list of being one of the nation’s most creative users of business …show more content…
They can also pull their insurance cards up through the app so they do not have to worry about keeping their cards on them at all times, which seems to be one thing that a lot of people forget to bring in an emergency. Keeping up with the technology in this way has helped the company continue to grow, with a lot of the millennials starting to carry their own insurance and making their own choices on healthcare coverage. Medical Mutual also has a Quality Improvement Program set up which basically is designed to constantly improve the quality of the healthcare services that are available for members. They have an entire department employed that manages the cost-effectiveness, implementation of services and evaluates the plans that are offered for quality. In being so active in their “customer service” it allows the members to feel safe and taken care of, which will keep them coming back year after year for coverage. They also have numerous discounts available to all members for wellness programs, from adults to babies. These discounts will not only keep members coming back but it is also helping them get healthier, which is keep lowering costs for the company when less and less people have to go to the doctor. This is a smart business move for the company, looking like a win-win decision for them, keeping the members happy and also keep the revenue coming …show more content…
They listed these changes, and when they would come into effect right on their website for all their members to read and understand before anything changed. It also listed the rate increase that would come along with all the changes well in advance, given the members ample time to prepare for the jump. Keeping the members “in the loop” was a smart choice for them. There aren’t many things people hate more than to be surprised by

Similar Documents

Premium Essay

Violation of Patient Consent

...The case that I decided to speak about is the 2009 Medical Mutual of Ohio vs. Schlotterer. In this case a practicing physician was charged with being guilty of releasing sensitive patient medical records but, he made sure of all of them had physically signed what he thought would serve as an authorization to release form. So, how is it that he’s still being charged for releasing records that had a patient signature attached to it giving the authorization? It’s because “under R.C. 2317.02 (B) (1), medical records are generally privileged from disclosure” (Moyer, 2009), and instead of Dr. Schlotterer being safe and ensuring that his office was operating in an honorable manner he, just as most people do when they achieve great success but still not satisfied, got greedy. Dr. Schlotterer was able to feed his greed by way of his unknowing patients. He would have “consent forms” in his office that would read; “you consent to the release of medical information to Medical Mutual when you enroll and/or sign an application” or “when you present your identification card for covered services, you are also giving your consent to release medical information to Medical Mutual. Medical Mutual has the right to refuse to reimburse for covered services if you refuse to consent to the release of any medical information” (Moyer, 2009). To me that sounds like an involuntary agreement if a person wants to be seen by a physician in his office, which is not right because a patient has the right to decide...

Words: 673 - Pages: 3

Free Essay

Appendix E Matrix

...Associate Level Material Appendix E Insurance Matrix Type of Insurance Functions Example of Company Coverage Characteristics Auto The primary function of auto insurance is to make sure every driver on the road is financially responsible for their actions. In some states you may use other means to meet financially responsible guidelines, such as putting up a cash deposit with the Department of Motor Vehicles (DMV) or using a surety bond. With the small amount of cash needed auto insurance is the most common way to meet financial responsibility requirements to drive on the road. A clearer definition of the function of auto insurance can be viewed by looking at the regulations in place in the state you live. This is due to car insurance being regulated not at the federal level but at the state level. The ultimate function of insurance is to make the situation as right as possible. To restore things back to the way they were prior to the accident. If you were injured, you have to be healed. If your car got damaged, it would be repaired. If your car died on the road, towing insurance would be used to bring it to a repair shop. Your car is one of the most expensive things you own and insurance protects that investment. It provides you with a way of dealing with accident expense and trauma, theft and securing a loan on the car. Your car is a bold, heavy, machine which moves at fast speeds. As the owner, you have an obligation for the safety of passengers, other drivers, pedestrians...

Words: 901 - Pages: 4

Premium Essay

Arnold Palmer

...Arnold Palmer Case Overview: Arnold Palmer Hospital specializes in the treatment of women and children, and is renowned for providing one of the highest quality medical services and records of high patient satisfaction. This, however, requires costly inventory, most notably of custom surgical packs. In line with this, the hospital tied up with a major distributor partner, McKesson General Medical, which provides them with one-quarter of their medical/surgical inventory. This reduces their expenditures and helps them keep the quality of their inventory just in time for the scheduled operations that need them. Case Analysis: The hospital has managed to form a JIT partnership with one of its major supplier, McKesson General Medical.  To ensure coordinated daily delivery of inventory, McKesson has placed a full time account executive and two service personnel  to the hospital. This has reduced daily in-house inventory from 400,000 to 114,000. Arnold Palmer and Mckesson has designed a system for  custom surgical packs. A packing company assembles the customs packs with the order requirements of McKesson. The surgical packs are packed in a way that each item comes out of the pack in the sequence it is needed. Problems may arise if the items are not in order when opened for operations. The hospital  has 10 custom packs being used in the system. Surgical Staff of the hospital work with the hospital to identify and standardize and reduce the number of custom packs. ...

Words: 429 - Pages: 2

Premium Essay

Rocky Mountain/Mutual

... Assignment Written Analysis of Cases Rocky Mountain Mutual : Promoting Fun or Fitness? Submitted By : Sachin Watts 14PGDM046 Persuasive Memo on Fitness Center at Rocky Mountain Mutual To: Mr. Zachary Evans, Vice President of Operations From: Joseph Mirola JM Date: July 13,2014 Subject: Company Fitness Center makes a profit Thank you for allowing me to explain to you the benefits of having the company fitness center. Company reports indicate that the Fitness Center has led to an overall decrease in employee absenteeism, reduction in employee medical costs, and an increase in productivity. Employees who have taken advantage of the Fitness Center miss half the amount of work days than employees who do not use the fitness center. This claim can be substantiated by the data attached with the memo. Also the medical costs are affected in a huge way given below : • Frequent users (10% using 3 times a week): Average medical cost of $100 per year. • Average users (25% using once or twice a week): Average medical cost of $300 per year. • Non-users (65%...

Words: 817 - Pages: 4

Free Essay

Emergency Plan

...Purpose The purpose of the Health and Medical section is to provide information which identifies the methods used in mobilizing and managing health and medical services in response to emergencies at Glover International Airport. These areas include treatment, transport and evocation of the injured, removal of deceased, disease control and prevention of contamination during emergencies. • Situation and Assumptions Glover International Airport provides basic emergency medical care response for the Airport and will request assistance from the city of Seattle and City or Tukwila Fire Departments as necessary. The Airport provides emergency medical services through ARFF personnel and on/off-site mutual aid emergency medical technicians. If mutual aid is not available, the use of triage will be utilized to ensure an efficient use of existing resources. The Airport strives to ensure its response is adequate to protect life and health for the first 12 to 24 hours without outside assistance. Large-scale incident will require outside agency support. The surrounding communities have a large contingent of Health and Medical resources to bring to bear. Many medical professionals will volunteer their services and Glover International Airport must be prepared to ensure their legitimacy. It should be noted that these resource might they be adversely affected by the emergency. All requests for additional health and medical support will be made though the on-site Law Enforcement and will...

Words: 1835 - Pages: 8

Premium Essay

Rocky Mountain Mutual: Promoting Fun or Fitness

...[pic] Written Analysis and Communication (WAC) Assignment Case: Rocky Mountain Mutual: Promoting Fun or Fitness Submitted By: Roll No-09 Student of EX-PGDM 2015-16 ROCKY Mountain Mutual Date: 18 Jun 2015 To: Zachary Evans Vice President of Operations From: Manager Claims. Subject: A report on Fitness Center at Rocky Mountain Mutual, as a long term benefit and continuation of the fitness centre. Thank you for inviting me to prepare a report of the benefits of fitness center in our company. From last few year reports indicate that the Fitness Center has led to an overall decline in employee absenteeism, drop in employee medical costs, and an enhance in productivity. Therefore, I attached details of the report for your review and consideration of fitness center in our company. Executive Summary: The Rocky Mountain Mutual is growing insurance company, the newly established headquarter situated far from the city. Fitness centre has been motivational factor to our young employee to work in the company, in contrast other competitor don’t have any fitness center. A review of company report identified that the fitness center helped to drop employee absenteeism, reduced company medical cost, and increases employee productivity which lead the financial asset of the company. It is true that participation of employee in fitness centre is not satisfactory as per our expectation. Hope appropriate attention with key leadership...

Words: 1307 - Pages: 6

Free Essay

Mister

...Come True Medical coverage in Africa is very low. Worst still, the underprivileged are excluded even from this very low coverage. For our dream to transform Africa into an island of prosperity to become reality, a number of initiatives such as providing medical coverage for the poor are necessary. This can be possible through the MC²s, which are actually rural development micro-banks whose mission is to drive the economic growth of the underprivileged, and because the underlying principle of the MC² approach is the pooling together of a community’s material and intellectual resources to promote its welfare. For the purpose of better understanding it is necessary to define micro-insurance and mutual association. A Mutual Association can be defined as “a not-for-profit-making and non compulsory association of people driven by solidarity and who through their contributions and by their democratic decisions undertake provident funding and mutual help to cover themselves against social risk.” Micro-insurance is a form of insurance requiring very low premiums from subscribers and whose objective is the optimum satisfaction of personal needs. Principles of A Mutual Association To achieve our objective to provide medical coverage to low and very low income people, we rely on the principle of collecting small amounts from every community member to ensure optimum satisfaction for the individual and the community as a whole. A mutual association is...

Words: 1284 - Pages: 6

Premium Essay

Hiram Walker Case Study

...The judge also instructed the jury that it did not matter whether the cow was with calf or not, that should have no bearing on their contract. Within the Supreme Court the approach was different; the court did take into consideration the status of the cow, whether she was barren or a breeder. How did the court apply its approach to the facts of the case? Within the Michigan Supreme Court, the final ruling on this case, the courts took into the consideration of the status of the cow. It was understood by the sale price of the cow that the cow was believed to be barren and not a breeder. Therefore, the contract was not enforceable since it was later discovered, before any monies changed hands that the cow was not barren and in deed was pregnant with a calf. The courts agreed that it was a mutual mistake by both parties to have believed that the cow was barren. Provide a detailed example of how the court's conclusion might be applied in a modern business...

Words: 1392 - Pages: 6

Free Essay

Appendix E Insurance Matrix

... | |Policies: (PAP) Individual coverage and family | | | | |automobile. (FAP) for several people in a family who | | | | |are driving the same car. | |Home |To cover the cost of re-building or fixing a home |Farmers, Allstate, Liberty Mutual. |Liability; responsibility for another person’s losses.| | |damage or destroy by fire, theft or other accidents. | |Property protection; in the case that the building is | | | | |damage in the event of fire, natural or others. | | |...

Words: 261 - Pages: 2

Premium Essay

Rocky Mountain

...Written Analysis and Communication Rocky Mountain Mutual: Promoting Fun or Fitness? Submitted to: Submitted by: Prof. Manaswini Acharya Roll No. : 15PGDM005 Section- A Date of Submission: 10th July 2015 ` MEMORANDUM From : Joseph Mirola, Claims Manager To : Mr. Zachary Evans, Vice President Operations Date : 10th July 2015 Subject : Benefits of Fitness Center This report includes a detailed analysis of the situation at hand and the different options available. The major criteria used to evaluate the case are Employee benefits and Cost to Company. After much analysis my recommendation would be to utilize the space used for fitness center in the optimized way wherein half of the space can be used for Corporate Information Systems and the other half can be used for fitness center. Executive Summary Rocky Mountain Mutual is a growing insurance company which had built a new headquarters complex in remote area in Utah. The complex was included with the fitness center featuring an indoor walking/running track, a swimming pool and an exercise room. As per the reports of the last two years, the medical costs and the absenteeism rates of 35 percent of employees who used the fitness center has reduced. Zachary Evans, the Vice President of Operations, who is profit centric, wanted the fitness center to shut down as it is expensive to maintain and run. Joe Mirola...

Words: 1284 - Pages: 6

Free Essay

General Hospital

...trying to devise a master plan to cut costs, increase revenues, expand current services, and add new services. Interpersonal conflict occurs when two or more individuals perceive that their attitudes, behaviors or preferred goal are in opposition (Hellriegel/Slocum, 2011). Once Hammer presented his ideas to Dr. Mark Williams, Director of Medicine an intrapersonal conflict was shown since he felt that all physicians act in the practice of good medicine and forcing them to adhere would make it harder to keep and attract new physicians. Intragroup conflict refers to disputes among some or all of a group’s members, which affects a group’s dynamics and effectiveness (Hellriegel/Slocum, 2011). Although Marge Harding’s father and brother are medical doctors, she isn’t wowed by their positions, doesn’t mind challenging physicians, and views them as one dimensional. This represents an intragroup conflict. Intergroup conflict refers to opposition, disagreements, and disputes between groups or teams (Hellriegel/Slocum, 2011). Dr. Williams and the rest of the attending physicians were against Dr. Boyers being fired and the possible legal liabilities for the EKG reports errors. Harding sent her assistant to the meeting to represent the fact that General Hospital...

Words: 1764 - Pages: 8

Free Essay

Impotence

...I * Intercourse * Antecedent * Perpetual * Either on the part of the woman or the woman * Absolute * Relative * By its nature Part II – Paragraph 2 of can.1084 * What to do in the case of doubt either before or after the marriage? Part III – Paragraph 3 of can. 1084 * Sterility * How can one prove? * Conclusion Introduction: Among the various matrimonial impediments affecting the licitness as well as the validity of the marriage contract, the impediment of impotence has been polarizing the attention of canonists, theologians and medical experts for centuries. Even at the present time, it represents ground for prolonged discussions on the inner interpretation of the impediment, and on the application of the principles to practical cases. This, we believe, is motivated by 2 main factors: impotence is an impediment based on the very law of nature and, as such, is out of reach of the Church power to dispense it, once it is shown present beyond reasonable doubt. Secondly, impotence, as a physical or physiological defect, is regulated essentially by medical science, which is involved in a constant process of development and improvement. This gives rise to extreme difficulty of combining harmoniously the medical notion with principles of canonical jurisprudence. However, in general, impotence may be defined as the incapacity of performing the marital act by which the spouses become one flesh. What is directly affected by a...

Words: 1905 - Pages: 8

Premium Essay

Adr5

...In the case presented, Donna Driver admitted liability in a car accident with Vic Victim. Her liability coverage through Gekko is $100,000. Vic’s medical bills alone are close to $100,000 and he may be granted more than that because of missed work and pain and suffering. Donna requested her insurance company to settle the case with Vic’s offer of $100,000. Gekko declines and at trial Vic wins $200,000. Donna had to file bankruptcy because of this loss and is now suing Gekko for not negotiating in good faith. You have asked me to research how the cases of Shaeffer, Whiting v. Grange Mutual Casualty Company, 1981 Ohio App. LEXIS 14351 (Ohio Ct. App. 1981) and Schneider v. Eady, 2008-Ohio-6747 (Ohio Ct. App. 2008) will affect our case with Donna Driver. In Shaeffer, Whiting v. Grange Mutual Casualty Company, 1981 Ohio App. LEXIS 14351 (Ohio Ct. App. 1981) the Ohio Court of Appeals ruled that liability insurance companies owe no duty to injured third-party claimants. The court stated that the plaintiffs had no relationship with the insurance company that required the company a duty of good faith to settle the claim without litigation. The only contractual duty the insurance company had with the plaintiffs “was to pay medical payment expenses pursuant to the terms of their insurance contract.” Id. Because the insurance company paid the limit of the insured medical liability, they lived up to their contract and had no other contractual duties owed the plaintiffs. The court held...

Words: 1030 - Pages: 5

Premium Essay

Planning

...On site and offsite emergency plans on chemical disaster Why Emergency Planning is required? After the incident of Bhopal gas disaster, the Factories Act has been amended and a new chapter i.e. Chapter IVA – provision relating to hazardous processes has been added to the Factories Act with addition of new provisions sec 41A, 41B, 41C, 41D, 41E, 41G & 41H covering all hazardous process industries. Under the provision of Sec 41B(4) every occupier shall with the approval of the Chief Inspector of Factories draw up an On-site Emergency Plan and detailed disaster control measures for his factory and make known to the workers employed therein and to the general public living in the vicinity of the factory the safety measures required to be taken in the event of an accident taking place. This is the statutory provision laid down in the act for preparation of On-site Emergency Plan to control disaster in the factories. Major accidents may cause emergency and it may lead to disaster, which may cause heavy damage to plant, property, harm to person and create adverse affects on production. Many disasters like Bhopal gas tragedy, Chernobyl nuclear disaster etc. have occurred at many places in the world causing heavy loss of life and property. Emergency situation arises all on a sudden and creates havoc and damage to person, property, production and environment. Therefore such situations and risks should be thought in advance and it should be planned before hand to tackle...

Words: 3353 - Pages: 14

Free Essay

The Application of Ethical Frameworks in Medicinal Practice

...Frameworks in Medical Practice Introduction Identified as two of the most vital qualities regarding professional ethics concerning nursing, confidentiality and trust compose the two essential components of any and all kinds of relationships between patients, colleagues and the general public for a nurse. This essay seeks to analyze the article entitled “Betraying trust or providing good care? When is it okay to break confidentiality?”, written by Nathanson (2000). This chosen article highlights the importance of confidentiality and the possible professional premises in which confidentiality is commonly brought to a breach by professionals. It delves into the ethically evident implications involved in a breach of confidentiality, how different ethical lenses propagated by different theories view the position of the nurse, and mentions some alternatives regarding the approach to problem solving. Implications of breach of confidentiality Mutual confidentiality between a patient and medical personnel finds its fulfillment when trust is gained between each other and the patient is assured that the personal matters regarding the lives of each remain within themselves. There is a severe break in confidentiality when any information regarding the patient is publicized without patient approval. It is not only unacceptable professionally, but is also so in regards to ethics, morality and legality. The results of such practice involves the patient not being transparent with medical personnel...

Words: 1092 - Pages: 5