An health plan's contract negotiation team consists of several skilled individuals from different areas. At least one of the members is responsible for evaluating the wording of specific clauses to ensure that the health plan's rights are protected, as well as to ensure that the contract is in compliance with state and federal regulation. By profession, this member of the contract negotiation team is typically
A) Amedical director
B) An attorney
C) Afinancial manager
D) Aclaims manager

Question

Quizplus · Accepted Answer

An attorney is typically responsible for evaluating the wording of specific clauses to ensure that the health plan's rights are protected, as well as to ensure that the contract is in compliance with state and federal regulation. Medical directors may provide clinical guidance, financial managers may handle financial aspects, and claims managers may work on reimbursement issues, but none of these roles typically involve legal contract review.

An Health Plan's Contract Negotiation Team Consists of Several Skilled