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When an Insurance Carrier Bases Reimbursement on a Code Level

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Short Answer

When an insurance carrier bases reimbursement on a code level lower than the one submitted by the provider, this is called ________.


Definitions:

Monopolistic Competition

Market in which firms can enter freely, each producing its own brand or version of a differentiated product.

Monopoly

A market structure characterized by a single seller controlling the entire supply of a unique product or service, without close substitutes.

Differentiated Products

Goods or services that are distinguished from similar products by characteristics like quality, features, or brand identity, leading to non-price competition.

Monopolistically Competitive

A market structure in which many firms sell products or services that are similar but not identical, allowing for competition on factors other than price.

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