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Author Question: According to some contract terms, if an MCO does not pay a claim within the time limit specified in ... (Read 13 times)

fahad

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on: Jun 27, 2018
According to some contract terms, if an MCO does not pay a claim within the time limit specified in the contract, the provider may be able to:
 
  A. bill the patient directly.
  B. charge the usual and customary fee instead of the discounted fee.
  C. take legal action against the MCO.
  D. terminate the MCO contract after filing a written notice of intention.

Question 2

Which type of payment method creates an incentive to provide more preventive care?
 
  A. Capitation
  B. Per diem
  C. Per case
  D. Discounted fee-for-service
Comprehensive Health Insurance: Billing, Coding, and Reimbursement ¦ Vines, Braceland, Rollins, Miller ¦ 3rd Edition
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wfdfwc23

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Reply #1 on: Jun 27, 2018
Answer to Question 1

Answer: charge the usual and customary fee instead of the discounted fee.

Answer to Question 2

Answer: Capitation


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fahad

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Reply #2 on: Jun 27, 2018
Correct answers!


wfdfwc23

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Reply #3 on: Jun 27, 2018
Great! Please up vote :D


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