The Provider Contract That Dr

question 26

Multiple Choice

The provider contract that Dr. Bijay Patel has with the Arbor Health Plan includes a no-balance-billing clause. The purpose of this clause is to:

• A) prohibit Dr. Patel from collecting payments from Arbor plan members for medical services that he provided them, even if the services are explicitly excluded from the benefit plan
• B) allow Dr. Patel to bill patients for services only if the services are considered to be medically necessary
• C) establish the guidelines used to determine if Arbor is the primary payor of benefits in a situation in which an Arbor plan member is covered by more than one health plan
• D) require Dr. Patel to accept Arbor's payment as payment in full for medical services that he provides to Arbor plan members

---

Definitions:

Fontanels

"Soft spots," or spaces, that separate the bones of the skull prenatally and in early infancy.

Skulls

The bony structures forming the head in vertebrates, housing the brain and providing support for the face and jaws.

Neuron

A nerve cell.

Axon

The main protruding branch of a neuron; it carries messages to other cells in the form of electrical impulses.