Chapter 5: Network Coverage

Question 1

What is Managed Care?

Answer 1

A health care delivery system created to control the rising cost of health care.

Question 2

Keeping the cost of care as low as possible without sacrificing quality by creating a network providers who have entered to accept negotiated rates, these providers are called?

Answer 2

Network providers or in-network providers.

Question 3

Patients will pay less out of their own pockets when receiving treatment form?

Answer 3

In-network providers.

Question 4

Out-of-network providers do not have a contractual relationship with the managed care plan because?

Answer 4

They did not agree to the discounted rates.

Question 5

If a patient chooses to receive care out of network, the insurer might not cover the cost, especially if?

Answer 5

They have an option for the service within their network.

Question 6

If a managed care plan does allow coverage for out-of-network care, the patient’s costs will always be?

Answer 6

Higher.