« previous next »

Author Question: According to some contract terms, if an MCO does not pay a claim within the time limit specified in ... (Read 58 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?

Many people have small pouches in their colons that bulge outward through weak spots. Each pouch is called a diverticulum. About 10% of Americans older than age 40 years have diverticulosis, which, when the pouches become infected or inflamed, is called diverticulitis. The main cause of diverticular disease is a low-fiber diet.

Did you know?

People who have myopia, or nearsightedness, are not able to see objects at a distance but only up close. It occurs when the cornea is either curved too steeply, the eye is too long, or both. This condition is progressive and worsens with time. More than 100 million people in the United States are nearsighted, but only 20% of those are born with the condition. Diet, eye exercise, drug therapy, and corrective lenses can all help manage nearsightedness.

Did you know?

The average person is easily confused by the terms pharmaceutics and pharmacology, thinking they are one and the same. Whereas pharmaceutics is the science of preparing and dispensing drugs (otherwise known as the science of pharmacy), pharmacology is the study of medications.

Did you know?

More than nineteen million Americans carry the factor V gene that causes blood clots, pulmonary embolism, and heart disease.

Did you know?

Individuals are never “cured” of addictions. Instead, they learn how to manage their disease to lead healthy, balanced lives.

English and Dani basic color terms. English and Dani basic color terms.
A completed CMS-1500 (02/12) claim form. A completed CMS-1500 (02/12) claim form.
The Gender Pay Gap Over Time: What Percentage of Men's Income Do Women Earn? The Gender Pay Gap Over Time: What Percentage of Men's Income Do Women Earn?
Time course for antibodies to the EBV viral–specific antigens. Time course for antibodies to the EBV viral–specific antigens.
How to evaluate algebraic terms containing fractional exponents without a calculator How to evaluate algebraic terms containing fractional exponents without a calculator
Write equilibrium constant expressions for the following reactions in terms of concentration: Write equilibrium constant expressions for the following reactions in terms of concentration:
Video: Mendel's Principles of Dominance, Segregation and Independent Assortment

For a complete list of videos, visit our video library