Answered step by step
Verified Expert Solution
Question
1 Approved Answer
Under the per diagnosis ( reimbursement ) contract between the provider ( Dr . Roman's cardiology office ) and insurer ( Humanah ) , the
Under the per diagnosis reimbursement contract between the provider Dr Roman's cardiology office and insurer Humanah the provider will be reimbursed in the range of $ to $ for any bone marrow transplantrelated procedures and treatments that are listedcoded under DRG Dr Roman performed a DRG listed procedure on Jennifer Lopeez that cost the provider $ in total.
Which of the following is true?
Group of answer choices
none of the choices listed here
The provider "broke even": Dr Roman's office will be reimbursed for any excess cost it incurred in Jennifer's case.
The insurer "lost": Humanah will have to reimburse Dr Roman for the excess cost it incurred in Jennifer's case "plus a percentage for growth" as defined in insurance and our textbook
The insurer "lost": Humanah will have to reimburse Dr Roman for the excess cost it incurred in Jennifer's case.
The provider "gained": Dr Roman's office will be reimbursed for any excess cost it incurred in Jennifer's case "plus a percentage for growth" as defined in insurance and our textbook
The provider "lost": Dr Roman's office will not be reimbursed for any excess cost it incurred in Jennifer's case.
Step by Step Solution
There are 3 Steps involved in it
Step: 1
Get Instant Access to Expert-Tailored Solutions
See step-by-step solutions with expert insights and AI powered tools for academic success
Step: 2
Step: 3
Ace Your Homework with AI
Get the answers you need in no time with our AI-driven, step-by-step assistance
Get Started