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2. Initial Post: Create a new thread and answer all three parts of the initial

prompt below
1. Discuss at least three (3) ways that managed care insurances affect a
physician's office.
2. Describe the differences between a participating provider and a non-
participating provider with Blue Cross Blue Shield.
3. What is a special accident injury rider with Blue Cross Blue Shield? Explain.
Complete your Reply Posts by Sunday at 11:59pm EST.

1 Answer

7 votes

Final answer:

Managed care insurances impact physician's offices financially, administratively, and in terms of treatment options. A participating provider contracts with an insurance company like Blue Cross Blue Shield, while a non-participating provider does not. A special accident injury rider with Blue Cross Blue Shield is an additional coverage option for accidents and injuries.

Step-by-step explanation:

Managed care insurances affect a physician's office in several ways:

  1. Financial Impact: Managed care plans often negotiate lower reimbursement rates with providers, which can result in reduced revenue for the physician's office.
  2. Administrative Burden: Physicians must adhere to the guidelines and requirements set by managed care plans, which can involve additional paperwork and administrative tasks.
  3. Limited Treatment Options: Managed care plans may have restrictions on certain treatments, medications, or specialists that a physician can refer patients to, which can limit the options available.

A participating provider with Blue Cross Blue Shield is contracted with the insurance company and agrees to the terms and reimbursement rates set by the insurer. A non-participating provider, on the other hand, does not have a contract with the insurance company and may not adhere to the same terms or receive the same level of reimbursement.

A special accident injury rider with Blue Cross Blue Shield is an additional coverage option that can be added to a health insurance policy. It provides coverage specifically for accidents and injuries, such as fractures, dislocations, or burns. This rider can help cover medical expenses related to accidents that may not be covered under the regular health insurance policy.

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