Dr Milton Ware, a Physician in the Riverside MCO's Network

question 34

Multiple Choice

Dr. Milton Ware, a physician in the Riverside MCO's network of providers, is reimbursed under a fee schedule arrangement for medical services he provides to Riverside members. Dr. Ware's provider contract with Riverside contains a typical no-balance billing provision. One purpose of this provision is to:

• A) prevent Dr. Ware from requiring a Riverside member to pay any coinsurance, copayment, or deductibles that the member would normally pay under Riverside's plan
• B) require Dr. Ware to accept the amount that Riverside pays for medical services as payment in full and not to bill plan members for additional amounts
• C) prevent Dr. Ware from seeking compensation from patients if Riverside fails to compensate him because of the MCO's insolvency
• D) prevent Dr. Ware from billing a Riverside member for medical services that are not included in Riverside's plan

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Definitions:

External Labour Supply

The availability of potential employees in the job market outside an organization that can be considered for hiring to fulfill HR demand.

Business Context

implies the combination of all internal and external factors that influence the operation and strategy of a company, including market conditions, competition, and regulatory environment.

HR Trends

Refers to the evolving strategies, tools, practices, and technologies in human resource management that aim to enhance employee performance, satisfaction, and retention.

E-Learning

Learning conducted via electronic media, typically on the Internet, involving educational content and courses.