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ME1125 week 3 assignment.docx - ME1125 Week 3 Assignment...

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© Ultimate Medical Academy. ME1125: Week 3 Assignment How will determining key elements of managed care plan contracts and communicating the effects of the contract for the practice broaden my career options? This assignment helps you apply your knowledge from this week’s modules and readings. As a medical office specialist, you may be expected to determine key elements of an insurance contract. You may also communicate possible impacts of payer partnerships. These tasks may decrease claim denials and increase practice revenue. Elements of Managed Care Contracts Answer the questions below. 1. Match the following elements of managed care contracts to their corresponding descriptions. J. capitation I. nonparticipating provider H. covered services G. benefit plan F. copayment E. coordination of benefits D. contracted services C. participating provider B. payer A. covered person C . A licensed healthcare professional who has entered into an agreement to provide covered services to covered individuals. G . Contract issued by a payer under which a covered person may be entitled to covered services. H . Healthcare services provided to covered persons under the terms of the benefit plan. F . The amount a covered person is required to pay at the time of service. E . The determination of which health plan will pay for covered services as primary or secondary payer. B . An insurance company, third-party administrator, or self-insured health benefit plan that is contractually obligated to make payments on behalf of covered persons.
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