Covington's Program

Question 1

Self insurance: this means that instead of paying ________ to _________, the employer medical plan would pay claims directly.

Answer 1

premiums

health insurance companies

Question 2

Replace _______________ with “open access” health plans.

Answer 2

insurance-contracted networks

Question 3

Billing and insurance related costs are estimated at 20 to 30% of revenues, which is why providers often offer “_____________” rates substantially lower than their ________________.

Answer 3

cash payment

insurance-contracted rates

Question 4

The plan adopts a “Medicare cost plus” fee schedule that pays providers a percentage–say 130%–of what Medicare pays. This fee schedule replaces _________, and thus the need for _________.

Answer 4

insurance-contracted rates

insurance-contracted network

Question 5

Northern California cash price payment rates are ____of insurance-contracted rates and Medicare rates average ____ of insurance-contracted rates.

Answer 5

35%

58%