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October 1, 1997

25. Doctor’s Visit

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You evaluate patients for a large health insurance company. It is company policy that if a patient’s condition has existed for more than three months before they seek treatment, the company will not pay for it. Patients, however, do not know this policy and often turn in a claim that is more than three months old. Usually, these patients simply did not think their problem warranted a doctor’s visit until now. If you fudge the dates on their medical records, they can receive treatment, but if you are honest, they will most likely be turned down. What should you do?

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