Question

Compare the procedures for filing fee-for-service and managed care claims under Medicaid.

Answer 1

Fee for service is a payment method in the Medicaid where the physicians are paid for their each services .It depends on the quantity of care provided rather than the quality of care.It gives incentives to the physician. It simply unbundled the care.Here the healthcare provider collects the insurance details from patients submits to insurance company for each services and then the payment are initiated.

Managed card claims are one of the common insurance one has in US.It includes policy holder (patient),healthcare provider (Doctors ) and Insurance company. Here the policy holder when makes a hospital visit for getting treated of their illness they are supposed to submit their insurance details to the healthcare provider .Thereafter the healthcare provider and the insurance company starts working.The claim when received by the insurance company first verifies it and gives either acceptance or rejection.Once when accepted the claim is processed and then th payment is initiated to the health care provider