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the National Committee for Quality Assurance (NCQA), a non-profit organization that also collects and disseminates health plan performance data.

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14y ago

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when a managed care organizations provides bonuses to physicians for providing fewer tests?

Many managed care organizations require referrals from primary care physicians to specialists


What was the primary reason for the rise of managed care organizations in the US?

baby boomers


Do you need a referral when you have a MCO?

Many managed care organizations require referrals from primary care physicians to specialists. Some do not.


What has the author Colodia Owens written?

Colodia Owens has written: 'Managed Care Organizations' -- subject(s): Managed Care Programs, Managed care plans (Medical care)


Is it mandatory for all managed care organizations to be accredited?

yes


What are the four types of managed care plans?

The four types of managed care plans are health maintenance organizations (HMOs), preferred provider organizations (PPOs), exclusive provider organizations (EPOs), and point-of-service plans (POS).


Managed care organizations evaluate the provider through a blank process?

Credentialing


What is health maintenance organizations and other managed care organizations?

# McCAP # BLUE CROSS BLUE SHIELD # RED CROSS


How does managed care organizations deal with patients who have both medicaid and medicare?

This would be a very rare situation, I think. In such a case, the managed care organization would be the primary insurer and Medicare secondary. Medicaid is always the payor of last resort. However, there shouldn't be any expenses for Medicare or Medicaid to pay.


What has the author Sarah Feldman written?

Sarah Feldman has written: 'Managed care and provider volume' -- subject(s): Econometric models, Managed care plans (Medical care), Preferred provider organizations (Medical care)


Which term refers to a managed care plan that traditionally requires coordination of healthcare through a primary care physician?

HMO


What has the author Kathleen S Penkert written?

Kathleen S. Penkert has written: 'Marketing to managed care organizations' -- subject(s): Marketing, Child mental health services, Managed mental health care