A Provider in a Managed Care Network Who Does NOT

question 79

Short Answer

A provider in a managed care network who does NOT provide a sufficient level of treatment to patients because of a capitation agreement is committing which type of fraud?
A)Underutilization
B)Overutilization
C)Internal fraud
D)Unbundling

• A)Underutilization
• B)Overutilization
• C)Internal fraud
• D)Unbundling

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Definitions:

Social Learning

The process of learning behaviors through the observation of others, rather than through direct experience.

Information Processing

The method by which individuals take in, consider, and utilize data or information, drawing heavily from cognitive psychology.

Classical Conditioning

A process of acquiring knowledge through the connection of a stimulus present in the surroundings with one that occurs spontaneously.

Operant Conditioning

A method of learning in which the force of a behavior is shaped by the use of rewards or sanctions.