Question

A provider who has a contractual agreement to accept an insurance company’s pre-negotiated rate for healthcare services is considered to be?

Answer 1

Pre-negotiated rates are the amounts paid (dollar amount or percentage) by the patient for any health care services provided by the in-network provider. More out of pocket expenses could be expected if the patient wants to use a non-network provider, as non-network providers have not contracted with the insurance company for a fee schedule. Most insurance companies operate as "for-profit" (employers sponsored or individual plans) as opposed to "not for profit" (SCHIP, TRICARE, state and federal programs).

Answer 2

The type of health insurance that enables healthcare providers to accept insurance payments to provide specific health services to members at a negotiated rate is called a health medical care organization.

Explanation:

Health medical care organization is a kind of medical insurance that allows the patients to seek health facilities at a negotiated amount of the annual fee.

The providers have agreed to the payment methods and the negotiated amounts proposed by the health medical care organization in exchange for a steady amount of customers.

The health medical care organization is regulated at the federal as well as the state levels in the U.S.