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Medical Insurance Chapter 13th BlueCross BlueShield Exam Study Guide with Complete Solutions $9.99   Add to cart

Exam (elaborations)

Medical Insurance Chapter 13th BlueCross BlueShield Exam Study Guide with Complete Solutions

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Medical Insurance Chapter 13th BlueCross BlueShield Exam Study Guide with Complete Solutions One of the requirements that a participating provider must comply with is to - Answer️️ -make fee adjustments for the difference between amounts charged to patients for services provided and payer-...

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  • September 13, 2024
  • 8
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Bluecross Blueshield
  • Bluecross Blueshield
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Medical Insurance Chapter 13th
BlueCross BlueShield Exam Study
Guide with Complete Solutions


One of the requirements that a participating provider must comply with is to -

Answer✔️✔️-make fee adjustments for the difference between amounts charged to

patients for services provided and payer-approved fees.

Which is a program that requires providers to adhere to managed care provisions? -

Answer✔️✔️-preferred provider network (PPN)

One of the expectations that a nonparticipating provider has is to _____ for services

rendered. - Answer✔️✔️-obtain payment for the full fee charged

Which is considered a minimum benefit under BCBS basic coverage? - Answer✔️✔️-

hospitalizations

Which is considered a service reimbursed by BCBS major medical coverage? -

Answer✔️✔️-mental health visits

Which is a special clause in an insurance contract that stipulates additional coverage

over and above the standard contract? - Answer✔️✔️-riders

BCBS indemnity coverage is characterized by certain limitations, including - Answer✔️✔️-

hospital-only or comprehensive hospital and medical coverage

Prospective authorization or precertification is a requirement of the _____ BCBS

managed care plan. - Answer✔️✔️-outpatient pretreatment authorization

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