Which of the Following Is NOT a Way in Which

question 58

Multiple Choice

Which of the following is NOT a way in which managed care organizations may influence and/or control the patient's choices in selecting health care services:

• A) The patient's PCP must be a participating provider.
• B) Only approved services may be reimbursed.
• C) The managed care organization decides what services are "medically necessary."
• D) The managed care organization only pays for services provided by the PCP.

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Definitions:

Gross Margin

The variance between the revenue generated from sales and the cost incurred from goods sold, calculated as a fraction of the sales revenue.

Net Operating Income

The total profit of a company after operating expenses are subtracted from operating revenues.

Margin

Describes profit as the difference between sales and the costs of goods sold, often expressed as a percentage of sales.

Return on Investment

A measure of the profitability of an investment, calculated as the net gain from an investment divided by the cost of the investment.