The Following Statements Are About Some of the Issues Surrounding

question 85

Multiple Choice

The following statements are about some of the issues surrounding the contractual responsibilities of health plans. Select the answer choice containing the correct statement.

• A) Typically, health plans are required to pay completed claims within 10 days of submission. 26
• B) Health plans typically are prohibited from examining the financial soundness of a self-funded employer plan that relies on the health plan to pay providers for services received by the plan's members.
• C) Patient delivery is one of the most significant factors that health plans consider when determining whether provider services should be reimbursed on a capitated or fee-for-service (FFS) basis.
• D) Health plans require all providers to agree to an exclusive provider contract.

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Definitions:

Dividends

A portion of a company's earnings distributed to shareholders as a reward for their investment.

Par Common Stock

The face value of common shares issued by a company, which is noted on the share certificate.

No-Par Common Stock

Shares of common stock issued without a par value, which means they are not assigned a nominal face value.

Treasury Stock

Shares of a company's own stock that it has reacquired and held in the company's treasury.