Health plan administrators are designing methods to assure that consumers have appropriate access to emergency services. Which standard should guide the development of these methods?

Question

Quizplus · Accepted Answer

Rationale 1: The standard of a reasonable physician would exclude many situations for which people believe they should seek emergency care.
Rationale 2: The standard for access to emergency care should be such that a "prudent layperson" could reasonably expect the absence of medical attention to place the consumer's health in serious jeopardy.
Rationale 3: An ethical insurance provider's standard for when a person should have access to emergency care may be influenced by reimbursement issues.
Rationale 4: A prudent and reasonable nurse has a higher understanding of medical emergencies. Because of this advanced knowledge this is not the standard for most people.

Health Plan Administrators Are Designing Methods to Assure That Consumers