« previous next »

Author Question: According to some contract terms, if an MCO does not pay a claim within the time limit specified in ... (Read 60 times)

fahad

  • Hero Member
  • *****
  • Posts: 570
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
Buy Test-Bank


wfdfwc23

  • Sr. Member
  • ****
  • Posts: 338
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


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question

fahad

  • Hero Member
  • *****
  • Posts: 570
Reply #2 on: Jun 27, 2018
Correct answers!


wfdfwc23

  • Sr. Member
  • ****
  • Posts: 338
Reply #3 on: Jun 27, 2018
Great! Please up vote :D


« previous next »
 

Did you know?

HIV testing reach is still limited. An estimated 40% of people with HIV (more than 14 million) remain undiagnosed and do not know their infection status.

Did you know?

This year, an estimated 1.4 million Americans will have a new or recurrent heart attack.

Did you know?

For about 100 years, scientists thought that peptic ulcers were caused by stress, spicy food, and alcohol. Later, researchers added stomach acid to the list of causes and began treating ulcers with antacids. Now it is known that peptic ulcers are predominantly caused by Helicobacter pylori, a spiral-shaped bacterium that normally exist in the stomach.

Did you know?

The first war in which wide-scale use of anesthetics occurred was the Civil War, and 80% of all wounds were in the extremities.

Did you know?

Walt Disney helped combat malaria by making an animated film in 1943 called The Winged Scourge. This short film starred the seven dwarfs and taught children that mosquitos transmit malaria, which is a very bad disease. It advocated the killing of mosquitos to stop the disease.

Understanding cells in terms of their molecular components. Understanding cells in terms of their molecular components.
Barenaked Ladies - Lovers in a Dangerous Time Barenaked Ladies - Lovers in a Dangerous Time
Commonly Misspelled Medical Terms Commonly Misspelled Medical Terms
Using a vacuum hose and a grounded test light to ground one cylinder at a time on a DIS. This works ... Using a vacuum hose and a grounded test light to ground one cylinder at a time on a DIS. This works ...
Graph showing oral administration of a single-dose drug. The time of onset is 2 hours and the end of ... Graph showing oral administration of a single-dose drug. The time of onset is 2 hours and the end of ...
Very nice definition of time Very nice definition of time
Video: Acid-base imbalances - respiratory acidosis and alkalosis

For a complete list of videos, visit our video library