Name and describe three methods used by most payers to set the fees that health plans...

Question

Question

Name and describe three methods used by most payers to set the fees that health plans will pay physicians.

Answer 1

Answer #1

3 payment method that are used are

1)fee for services -they get paid for every test and services.

2)discounted fee for service-they are paid for on the basis of fee schedule, that is predetermined by the local physicians there.

3)capitation-they are not paid monthly or on service basis, rather than paid a fix amount per patient.

Answer 2

Similar Homework Help Questions

Marketplace of health insurance plans for consumers Question6 Physicians generally base their fees on all the...

Marketplace of health insurance plans for consumers Question6 Physicians generally base their fees on all the following except O extent and complexity of service. O distance traveled by patient. O customary fees charged by other local physicians operating costs. O utilization management Question 7 1 pts Medicare covers all the following except
Describe the methods used in the social science disciplines and with the population health model to...

Describe the methods used in the social science disciplines and with the population health model to define the pathways between the social determinants and health.
1. What are the methods of data collection used in health services research? Describe their characteristics?...

1. What are the methods of data collection used in health services research? Describe their characteristics? 2. What do researchers take into account in selecting a data collection method? 3. Compare the strengths and weaknesses of mail questionnaire surveys and personal and telephone interviews. What situations are most suitable for each of these methods? 4. What measures can be used to improve both the quantity and quality of the responses?

healthcare services Health insurance plans pay physi usual charge, does not exceed t service by the...

healthcare services Health insurance plans pay physi usual charge, does not exceed t service by the other physicians i UCR reasonable 5. Describe two (2) types of payment models. a Type answer her b. Type answer here 6. List three (3) advantages and three (3) disadvantages Oo e
Which payment model provides the least financial risk for payers and the most financial risk for...

Which payment model provides the least financial risk for payers and the most financial risk for providers? Question 14 1 pts What service line does more than half of all NHS expenditures go towards? Acute hospital care, including hospital-based physician services O Primary care services Acute hospital care, excluding hospital-based physician services Community & public health services Question 15 1 pts 60% of all primary care physicians working for the NHS are on nationally negotiated contracts. Which payment models are...
Name and describe an organizational control mechanism used at your health agency.

Name and describe an organizational control mechanism used at your health agency.

The Cost of the U.S. Health Care System Describe three different reimbursement methods (e.g., capitation, fee-for-service...

The Cost of the U.S. Health Care System Describe three different reimbursement methods (e.g., capitation, fee-for-service [FFS], pay-for-performance [P4P], value-based, episode of care, prospective reimbursement, diagnosis related group [DRG], patient-centered medical home [PCMH]). Explain why you think one of the reimbursement methods you discussed is more effective at reducing health care costs overall while still ensuring the delivery of quality care. Describe the use of two technological advancements (e.g., electronic medical record [EMRs], electronic health records [EHRs], medical research, improved...
In a 1,000-word written assignment, describe three data gathering methods that you would use in the...

In a 1,000-word written assignment, describe three data gathering methods that you would use in the development and application of organizational plans. Explain why these methods would produce the best results to be used in organizational planning.
Briefly name and describe the THREE methods scientists commonly use to determine how long ago (in...

Briefly name and describe the THREE methods scientists commonly use to determine how long ago (in years) a currently extinct species lived.

Describe and discuss three methods used to manage utilization during the course of hospitalization be sure...

Describe and discuss three methods used to manage utilization during the course of hospitalization be sure to describe and provide examples as a support