« previous next »

Author Question: According to some contract terms, if an MCO does not pay a claim within the time limit specified in ... (Read 65 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?

When taking monoamine oxidase inhibitors, people should avoid a variety of foods, which include alcoholic beverages, bean curd, broad (fava) bean pods, cheese, fish, ginseng, protein extracts, meat, sauerkraut, shrimp paste, soups, and yeast.

Did you know?

Drying your hands with a paper towel will reduce the bacterial count on your hands by 45–60%.

Did you know?

The cure for trichomoniasis is easy as long as the patient does not drink alcoholic beverages for 24 hours. Just a single dose of medication is needed to rid the body of the disease. However, without proper precautions, an individual may contract the disease repeatedly. In fact, most people develop trichomoniasis again within three months of their last treatment.

Did you know?

Side effects from substance abuse include nausea, dehydration, reduced productivitiy, and dependence. Though these effects usually worsen over time, the constant need for the substance often overcomes rational thinking.

Did you know?

After a vasectomy, it takes about 12 ejaculations to clear out sperm that were already beyond the blocked area.

Old Time Farm Shepherd Old Time Farm Shepherd
Attention and memory are in demand during circle time. Attention and memory are in demand during circle time.
Instructions for Completing the CMS-1500 (02/12) Claim Form Continued Instructions for Completing the CMS-1500 (02/12) Claim Form Continued
Sterilization Time Requirements Cont Sterilization Time Requirements Cont
Greet a First-Time Client With a Firm Handshake. Greet a First-Time Client With a Firm Handshake.
Jim Croce - Time in a bottle - 1973 Jim Croce - Time in a bottle - 1973
Video: Lipid catabolism - lipolysis and beta oxidation and oxidation of fatty acids

For a complete list of videos, visit our video library