Question

A(n) _ ____is a review of individual cases by a committee to make sure services are...

A(n) _ ____is a review of individual cases by a committee to make sure services are medically necessary and study how providers use medical care resources?

A(n) __ __is a healthcare provider who enters into a contract with a specific insurance company or program and agrees to accept the contracted fee schedule.?

The_______________ is the maximum that third-party payers will pay for a procedure or service

One of the medical assistant’s responsibilities is verifying eligibility. Describe the processes available for the verification of eligibility for services

Homework Answers

Answer #1

Answer 1: Utilization review. It a review of individual cases by a committee to make sure services are medically necessary and study how providers use medical care resources.

Answer 2: Participating provider. It is healthcare provider who enters into a contract with a specific insurance company or program and agrees to accept the contracted fee schedule

Answer 3: Allowable amount: It is the maximum that third-party payers will pay for a procedure or service

Answer 4: The processes available for the verification of eligibility for services as the medical assistant need to contact at the phone number of the provider services desk or by visiting the online web portal. This could enable the verification process.

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