Answered step by step
Verified Expert Solution
Link Copied!

Question

1 Approved Answer

16. A member, covered under an HMO plan, had a 7 day non-emergent inpatient stay at a hospital not in the health plans network. The

16. A member, covered under an HMO plan, had a 7 day non-emergent inpatient stay at a hospital not in the health plans network. The total charges for the stay were $42,000. The inpatient rate at in-network hospitals is a per diem of $1,000. What payment is the hospital entitled to?

A. $10,000

B. $7,000

C. $42,000

D. $25,000

18.True or False: Non-profit health plans must set the premium to equal the total medical cost to ensure the organization earns no profit:

A. True

B. False

Step by Step Solution

There are 3 Steps involved in it

Step: 1

blur-text-image

Get Instant Access to Expert-Tailored Solutions

See step-by-step solutions with expert insights and AI powered tools for academic success

Step: 2

blur-text-image

Step: 3

blur-text-image

Ace Your Homework with AI

Get the answers you need in no time with our AI-driven, step-by-step assistance

Get Started

Recommended Textbook for

Handbook Of Research On Theory And Practice Of Financial Crimes

Authors: Abdul Rafay

1st Edition

1799855678, 978-1799855675

More Books

Students also viewed these Finance questions