The Following Statements Are About the Responsibilities That Providers Are

question 34

Multiple Choice

The following statements are about the responsibilities that providers are expected to assume under most provider contracts with health plans. Select the answer choice containing the correct statement.

• A) All health plans now include in their provider contracts a statement that explicitly places responsibility for the medical care of plan members on the health plan rather than on the provider.
• B) According to the wording of most provider contracts, the responsibility of providers to deliver medical services to a plan member is not contingent upon the provider's receipt of information regarding the member's eligibility for these services.
• C) Most health plans include in their provider contracts a clause which requires providers to maintain open communication with plan members regarding appropriate treatment plans, even if the services are not covered by the member's health plan.
• D) Most provider contracts require participating providers to discuss health plan payment arrangements with patients who are covered by the plan.

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Definitions:

Across Cultures Competency

The capacity to comprehend, converse, and engage successfully with individuals from different cultural backgrounds.

KSAs

Stands for Knowledge, Skills, and Abilities; key components that individuals need to perform a job effectively.

Motivating Employees

The process of inspiring and encouraging employees to perform their best through various strategies, rewards, and recognitions.

Empathizing Skill

The ability to understand and share the feelings of another person, often facilitating more effective communication and relational bonds.