Author Question: A percentage of a providers' payment that is NOT paid during a contract year but is kept by the ... (Read 86 times)

Yi-Chen

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A percentage of a providers' payment that is NOT paid during a contract year but is kept by the health plan to offset additional costs incurred for referrals, hospital admissions, or other covered services is called a:
 
  disincentive.
 
  per-member-per-month (PMPM) fee.
 
  withdrawal.
 
  withhold.

Question 2

The types of payments that an insured person is responsible for paying include all of the following EXCEPT:
 
  deductibles.
 
  charges over the allowed amount for a participating provider.
 
  charges over the allowed amount for a nonparticipating provider.
 
  charges for excluded services.



amynguyen1221

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Answer to Question 1

Answer: withhold.

Answer to Question 2

Answer: charges over the allowed amount for a participating provider.



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