Which of the following statements about major medical insurance policies that reimburse physicians on the basis of reasonable and customary charges is (are)true?
I.To determine if a fee for a medical procedure is reasonable and customary,it is compared to what other physicians in the same area charge for the procedure.
II.A schedule of surgical procedures and dollar amounts payable is included in the policy and all surgeons are paid the scheduled amount for the same procedure.

Question

Quizplus · Accepted Answer

Statement I is true - major medical insurance policies that reimburse physicians on the basis of reasonable and customary charges compare fees for medical procedures to what other physicians in the same area charge for the procedure. Statement II is false - major medical insurance policies that reimburse physicians on the basis of reasonable and customary charges do not include a schedule of surgical procedures and dollar amounts payable, and surgeons are not all paid the same amount for the same procedure.

Which of the Following Statements About Major Medical Insurance Policies