According to Some Contract Terms, If an MCO Does Not

question 24

Multiple Choice

According to some contract terms, if an MCO does not pay a claim within the time limit specified in the contract, the provider may be able to:

• A) bill the patient directly.
• B) charge the usual and customary fee instead of the discounted fee.
• C) take legal action against the MCO.
• D) terminate the MCO contract after filing a written notice of intention.

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Definitions:

ATC

Average Total Cost; the total cost of production (fixed and variable costs combined) divided by the number of units produced.

Price Charged

The amount of money a buyer has to pay to acquire a product or service from a seller.

Marginal Revenue

The revenue that a company gains by selling an additional unit of a product, indicating the income effect of increasing output by one unit.

Marginal Cost

The additional financial burden of creating another unit of a product or service.