Author Question: Medicare and many states prohibit managed care contracts from containing __________, which prevent ... (Read 28 times)

CORALGRILL2014 · **on:** Jun 27, 2018

Medicare and many states prohibit managed care contracts from containing __________, which prevent providers from discussing all treatment options with patients, whether or not the plan would provide reimbursement for services.
a. credentialing statements
b. gag clauses
c. physician incentives
d. profit margins

Question 2

Prior to scheduling elective surgery, managed care plans often require a __________ during which another physician is asked to evaluate the necessity of surgery and recommend the most economical, appropriate facility in which to perform the surgery.
a. preauthorization
b. prospective review
c. retrospective review
d. second surgical opinion