Which of the following best describes a carve-out service?
a. A particular service that is offered only by a designated provider or group.
b. A particular procedure that receives limited reimbursement.
c. A particular treatment is not allowed within a particular diagnosis.
d. A particular prescription drug that is only available to those with certain conditions.
ANS: A
Carve-out services might be designated for those who need the services the least. A carve-out service (for example, mental health care) is provided within a standard benefit package but delivered exclusively by a designated provider or group. The other definitions do not correctly describe a carve-out service.
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