Question

1- Outline (list)managed care requirements for patient referrals.

2- List three examples of insurance fraud and three examples of insurance abuse

Answer 1

These ins mance plans lequire patients to select a PCP and PCP document must manage their healthier → The patient cannot self defee and must obtain approval from their PCP prior to any speciality visits These patients may seek medical care where ever they choose as they don't need eefueals Insurance fraud - Application feand - It is when you knowingly provide incorrect information to you insurance company when your applying for a ® death fraud policy ③ Claims feaud @ Fagery feaud Insurance abuse Using economic abuse: Using emotional abuse Using Children Using male privilege. Using Colecion and theeate