A Health Plans Coverage Policies Are Linked to Its Purchaser

question 23

Multiple Choice

A health plans coverage policies are linked to its purchaser contracts. The following statement(s) can correctly be made about the purchaser contract and coverage decisions: 1.In case of conflict between the purchaser contract and a health plans medical policy or benefits administration policy, the contract takes precedence 2.Purchaser contracts commonly exclude custodial care from their coverage of services and supplies 3.All of the criteria for coverage decisions must be included in the purchaser contract

• A) All of the above
• B) 1 and 2 only
• C) 2 only
• D) 3 only

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Definitions:

Repayment Of Principal

The process of paying back the original amount borrowed in a loan, excluding any interest charges.

Effective Annual Return

The interest rate on an investment on an annual basis, accounting for the effect of compounding more than once per year.

Nominal Interest

The rate of interest before adjustments for inflation; the stated interest rate on a financial product.

Compounding

The process of finding the future value of a single payment or series of payments.