Question

Describe important payment issues that should be addressed in the managed care arrangement. What is the significant trend in provider payment arrangements?

Answer 1

1. Managed care arrangements is a type of health insurance they have contract with health care provider and medical facilities to provide care for member at reduced cost.

2. It has certain type like health maintanence organization, preferred provider organization and point of service.

3. Silent PPO is major issues on payment.

4. Non related insurance party issues.

5. Medical record payment issues.

6. Issues with co payment and reductable system.

7. Unbroken financial relationship.

Trend in provider payment arrangements:

1. Changing health care system.

2. Criteria and standards in selection of practitioner.

3. Financial initiatives.

4. Ongoing quality assurance program

5. Implementation of evidence based practice