QUESTION: 61

From the following answer choices, choose the type of clause or provision described in this situation.
The Idlewilde Health Plan includes in its provider contracts a clause or provision that allows the terms of the contract to renew unchanged each year.

Cure provision
Hold-harmless provision
Evergreen clause
Exculpation clause

Answer(s): C

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QUESTION: 62

From the following answer choices, choose the type of clause or provision described in this situation.
The provider contract between Dr. Olin Norquist and the Granite Health Plan specifies a time period for the party who has breached the contract to remedy the problem and avoid termination of the contract.

Cure provision
Hold-harmless provision
Evergreen clause
Exculpation clause

Answer(s): A

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QUESTION: 63

From the following answer choices, choose the type of clause or provision described in this situation.
The Aviary Health Plan includes in its provider contracts a clause or provision that places the ultimate responsibility for an Aviary plan member's medical care on the provider.

Cure provision
Hold-harmless provision
Evergreen clause
Exculpation clause

Answer(s): D

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QUESTION: 64

The following statements are about the responsibilities that providers are expected to assume under most provider contracts with health plans. Select the answer choice containing the correct statement.

All health plans now include in their provider contracts a statement that explicitly places responsibility for the medical care of plan members on the health plan rather than on the provider.
According to the wording of most provider contracts, the responsibility of providers to deliver medical services to a plan member is not contingent upon the provider's receipt of information regarding the member's eligibility for these services.
Most health plans include in their provider contracts a clause which requires providers to maintain open communication with plan members regarding appropriate treatment plans, even if the services are not covered by the member's health plan.
Most provider contracts require participating providers to discuss health plan payment arrangements with patients who are covered by the plan.

Answer(s): C

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