Medical Insurance Chapter 13th BlueCross BlueShield Exam Study Guide with Complete Solutions
3 views 0 purchase
Course
Bluecross Blueshield
Institution
Bluecross Blueshield
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-...
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
Page | 1
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller SophiaBennett. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.99. You're not tied to anything after your purchase.
