******* **** ******** *** ServiceFee *** ******* plans ******** *********** ***** ** *** ******** ********* *********** cost-based ************* ******** ******* *** ******** ** profitability The ******** **** **** ******* lower ******* **** ***** ****** ************ (including ********** charges)The ******** *** *** ******* ** determine ***** ******* A ********* **** ******** finding payer unwilling ** ****** to *** ************ **** schedule3 *** ************ ******** ** **** to *** ************ *** all procedure ********* *** ******** ***** **** ** ** compensated for the ********** procedure **** **** *** **** *** been ********* *** ************ ******** ***** **** diagnosis The ******** might be *********** ** *** ****** ********* ****** *** ************* **** if *** ********** *** simple *** ********* risk ****** ** *** services provided *** *** many to get ******** ****** ********** ******** ***** if *** prices *** ********* The provider ***** ** ***** ***** *** higher **** **** ** their ************ ****** the ****** ******************* **** ** *** patients make ****** ***** their capitation ********* **** ** *** patients make visits ****** ***** *************** ** ******* PlansThe point of ******* plan ****** clients ** *** ******** **** providers outside *** ******* ** *** physician makes the ******** *** whole **** is ******* ** the **** ******* ** the ******* ******* *** *** referral **** will *** coinsurance ********** ** other additional ****** ************ *** POS ** ********** *** ******** risks failing ** get * ************* if **** ** the **** ******** ****** the ******** ** not allowable They *** however ********** ** *** ********* **** ****** ***** they *** ******* of ************* ************ ********** ********** **************** in *** *** plan ** ********* ***** **** *** charge *** ***** **** ***** ****** ********* A ******** risk occurs ** *** **** ** the bulk ** the **** ** ********* *** ************ ******** provider will ** compensated *** those ********** ****** making * referral The ******** ***** losing ** **** ******* * ********* that is ********* ***** *** referral4 Per ************ ******** ** motivated ** the ******** ** ** * lower ************* The ******** ***** ** the ********* ******** ** ** * ****** reimbursement5 *** ******* ******** ***** if the referral involves * ******* **** *** ******* been ******** *** provider ***** ** *** ******** ******** * ******* **** they *** *** to provide *** *** ********* ******* Global ********** provider ***** ** the ******** gives ***** ******* *** provider risks losing ********** ******* ** ********** ************* ******** ***** **** ********* to patients **** **** exhausted ***** ******* ********** *** ******** ***** ** *** patient referred *** *** activated ***** capitation ************* ******** ************* *** is * ****** **** **** **** ** ******* providers on *********** ***** ******* the ******* providers may ** ********* *** ******* *** ****** * ******* ** ******** ******** providers **** * patient *** his ** her *** preference *** *** medical organization1 Cost basedIt ** ******* **** *** fall **** of *** ******** ******* ******** ** ********** costs can be **** out ** *** ******** Charge ******** ******* **** ****** *** network *** agreed upon ** *** ******* providers **** ** ** ********* based3 *** ****************** *** ********* within **** ******* plan ** cheap ***** ** *** ************ by the ******* ******* ***** ***** and treatment can ** done ******* of *** ******* ** ** ********** ***** Per ************** ** *** ******** ***** * ********* can be ********* ***** ** * ******* **** ** the ******* **** ***** ***** *** incurred ** *** subscriber5 *** ******* ******* ** ***** ***** *** ****** the network **** ******* ********* may ****** ** different terms than **** ** *** **** ****** ********* ** cheap to *** ****** providers as **** ****** ***** at ********** *** ************* **** ***** *** *** *** within the ******* **** *** ******* **** ****** ******* *** ****** on a ******** plan *** that *** ** *** * *********** ************* *** ******** ***** ** the ******** *** below *** capitation *** provider ***** if the ******* is above *** ************
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Managed Care Plans.docx
The work has not been graded but I like the output that was submitted to me. Is it possible for the same prof to do the next assignment I will be submitting? If possible, I will greatly appreciate it.
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