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The Following Statements Are About the Specialist Component of a Provider

Question 130

Multiple Choice

The following statements are about the specialist component of a provider panel. Select the answer choice containing the correct statement.


A) Ideally, a health plan should have every specialist category represented on its provider panel with appropriate geographic distribution.
B) Most specialist contracts do not ensure the provider's adherence to UM policies set up by the health plan.
C) No-balance-billing clauses are not desirable in health plan contracts with specialists.
D) In geographic regions where there is a shortage of PCPs, a health plan is not permitted to contract with specialists to perform primary care services, even for patients with chronic conditions.

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