Ramifications of Participation Contracts

Ramifications of Participation Contracts - might not have...

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Ramifications of Participation Contracts HCR 230 By Heather Lisowski When providers do the financial paper work is done the provider pays less then the fees are and the if it is more then paid the provider does not make a profit. Also there are a lot of rules that they have to follow like Introductory section (often called “recitals” and “definitions”) Contract purpose and covered medical services Physician’s responsibilities Managed care plan obligations Compensation and billing guidelines The positive out come on this is that they cover a lot of different charges and you
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Unformatted text preview: might not have to pay a co pay. The negative out come to this is that you never know what the provider covers or not. The only time you will know that they cover something is when you get done with the visit and you go to check out or when you get a bill in the mail two weeks after the visit was done and then you can call and file a clam with them. The discount fees are good to have to an extent but when you go and see the doctor or who ever you are seeing they might not even except that carrier and you will have to pay out of pocket for the whole visit....
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This note was uploaded on 04/26/2011 for the course HCR 230 taught by Professor Volk during the Spring '11 term at University of Phoenix.

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Ramifications of Participation Contracts - might not have...

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