The provider contract that Dr. Bijay Patel has with the Arbor Health Plan includes a no-balance-billing clause. The purpose of this clause is to:
A) prohibit Dr. Patel from collecting payments from Arbor plan members for medical services that he provided them, even if the services are explicitly excluded from the benefit plan
B) allow Dr. Patel to bill patients for services only if the services are considered to be medically necessary
C) establish the guidelines used to determine if Arbor is the primary payor of benefits in a situation in which an Arbor plan member is covered by more than one health plan
D) require Dr. Patel to accept Arbor's payment as payment in full for medical services that he provides to Arbor plan members

Question

Quizplus · Accepted Answer

The purpose of a no-balance-billing clause is to require healthcare providers, such as Dr. Bijay Patel, to accept the payment from the patient's insurance plan as payment in full for medical services, and not bill the patient for any additional amounts that may be owed. This helps to protect patients from unexpected additional costs and prevents providers from charging additional fees beyond what the insurance plan covers.

The Provider Contract That Dr