An Alliance Should Demonstrate the Low Risk of Anticompetitive Harm

question 20

Multiple Choice

An alliance should demonstrate the low risk of anticompetitive harm and pro-competitive _____ and efficiencies to be gained. 

• A) market manipulation
• B) boycotts
• C) benefits
• D) comfort letters

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Definitions:

Original Medicare

A federal health insurance program in the United States for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease, consisting of Part A (hospital insurance) and Part B (medical insurance).

Approved Charges

The amounts pre-determined by insurance providers as the maximum they will pay for a covered service or procedure.

X12 837

A standard format for electronically transmitting healthcare claim information from healthcare providers to payers, such as insurance companies.

Electronic Claim

A request for payment for healthcare services that is submitted electronically to a health insurance provider.