If a physician requests a peer review that results in confirmation that services were NOT medically necessary:
A) the patient should be billed for the review.
B) the insurance carrier will pay for the review.
C) there is no charge for the review.
D) the physician must pay for the review.
D) the physician must pay for the review.
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Which of these was designed to protect individuals who render care to an injured person from liability for civil damages that may arise as a result of providing emergency care?
A. Good Samaritan Act B. Settlement C. Contributory negligence D. Arbitration
Cataracts are categorized as a general condition of aging rather than a disease process
a. True b. False Indicate whether the statement is true or false
What should be prepared or updated for each participation contract?
A. plan summary grid B. formulary C. stop-loss provision D. repricer
Which of the following best describes the difference between volumes and capacities?
A) Capacities refer to combinations of volumes that express physiological limits. B) Volumes are discrete, whereas capacities represent functional combinations of volumes. C) Both a & b. D) None of the above.